Fırat Üniversitesi Tıp Fakültesi Kalp ve Damar Cerrahisi AD, Elazığ

Background: We evaluated the results of surgical treatment for peripheral vascular injuries. Methods: A total of 175 patients (148 males, 27 females; mean age 28 years; range 4 to 64 years) underwent surgical treatment for peripheral vascular injuries between January 1994 and February 2004. A retrospective evaluation was made concerning etiology, site of injuries, associated injuries, surgical methods, and the results of treatment. Results: The most frequent cause of injuries was penetrating trauma (%53.1). Injuries occurred in the upper extremity in 95 (54.3%), and in the lower extremity in 80 (45.7%) patients. The mean time to admission was 3.1 hours (range 10 minutes to 72 hours). A total of 171 arterial injuries were seen in 155 patients (88.6%), accompanied by venous injuries in 39.3%, peripheral nerve injuries in 28.3%, tendon injuries in 25.2%, and bone injuries in 20%. Isolated arterial and venous injuries were seen in 40 (22.9%) and 20 (11.4%) patients, respectively. Radial-ulnar arterial injuries were the most common (n=60, 35.1%), followed by femoral (n=43, 25.2%) and brachial (n=26, 15.2%) artery injuries. The most frequently injured vein was the femoral vein. Saphenous vein interposition (37.3%) was the most commonly applied method in the treatment of arterial and venous injuries. Amputation was required in five patients (2.9%), mainly because of complicated and contaminated injuries in three, and delayed presentation in two patients. Mortality developed in 11 patients (6.3%); of these, five had associated abdominal and thoracic injuries and two were in hypovolaemic shock. Three patients died due to crush syndrome, and one patient to septic shock. Conclusion: The type and site of injury, existence of accompanying lesions, and early surgical intervention are the most important factors affecting morbidity and mortality of peripheral vascular injuries.