Vasc Spec Int.  2019 Mar;35(1):16-21. 10.5758/vsi.2019.35.1.16.

Risk Factors of Amputation in Lower Extremity Trauma with Combined Femoropopliteal Arterial Injury

• Kim J
• Jeon YS
• Cho SG
• Hong KC
• Park KM

• KMID: 2448810
• DOI: http://doi.org/10.5758/vsi.2019.35.1.16

Abstract

PURPOSE
The clinical characteristics and results of femoropopliteal artery injury (FPAI) remain unclear. In this study, we evaluated the outcomes and risk factors of limb loss in patients treated for FPAI.
MATERIALS AND METHODS
We retrospectively reviewed data from a database of patients who underwent revascularization for an FPAI at a single institution between January 2013 and December 2017. We reviewed and analyzed the characteristics, postoperative results, and factors that influence amputation rates.
RESULTS
Twenty-four femoropopliteal arterial reconstructions in 24 patients were included in this study. Among the patients were 20 (83.3%) male with a first-quartile age of 28 years and a third-quartile age of 45 years (range, 15-68 years). The mean injury severity score (ISS) was 16 (range, 4-55), and 5 patients (20.8%) had ISSs of >20 points. The mean mangled extremity severity score (MESS) was 3.8 (range, 1-11), and 8 patients (33.3%) had MESSs of >5 points. In terms of arterial reconstruction methods, autogenous saphenous vein grafting, vein patching, and primary closure were performed in 9 patients (37.5%), 4 patients (16.7%), and 11 patients (45.8%), respectively. Despite arterial reconstruction, 5 patients (20.8%) underwent above-knee amputation. ISSs of >20, MESSs of >7, and orthopedic fixation were statistically significant factors associated with amputation.
CONCLUSION
In cases of FPAI with ISSs of >20, MESSs of >7, and orthopedic fixation, amputations should be considered. We were also careful to attempt limb salvage in such cases.

Keyword

Vascular injury; Femoral artery; Popliteal artery; Traumatic amputation

MeSH Terms

Amputation*
Amputation, Traumatic
Arteries
Extremities
Femoral Artery
Humans
Injury Severity Score
Limb Salvage
Lower Extremity*
Male
Orthopedics
Popliteal Artery
Retrospective Studies
Risk Factors*
Saphenous Vein
Transplants
Vascular System Injuries
Veins