Korean J Thorac Cardiovasc Surg.  2020 Oct;53(5):291-296. 10.5090/kjtcs.19.087.

Traumatic Peripheral Arterial Injury with Open Repair: A 10-Year Single-Institutional Analysis

• Cho H
• Huh U
• Lee CW
• Song S
• Kim SH
• Chung SW

• KMID: 2507345
• DOI: http://doi.org/10.5090/kjtcs.19.087

Abstract

Background
We report our 10-year experience with traumatic peripheral arterial injury repair at an urban level I trauma center.
Methods
Between January 2007 and December 2016, 28 adult trauma patients presented with traumatic peripheral arterial injuries. Data were retrospectively collected on demographic characteristics, the mechanism of injury, the type of vascular injury, and physiological status on initial assessment. The analysis also included the Mangled Extremity Severity Score (MESS), Injury Severity Score, surgical procedures, and outcome variables including limb salvage, hospital stay, intensive care unit stay, and postoperative vascular complications.
Results
Four (14.3%) patients required amputation due to failed revascularization. MESS significantly differed between patients with blunt and penetrating trauma (8.2±2.2 vs. 5.8±1.3, respectively; p=0.005). The amputation rate was not significantly different between patients with blunt and penetrating trauma (20% vs. 0%, respectively; p=0.295). The overall mortality rate was 3.6% (1 patient).
Conclusion
Blunt trauma was associated with higher MESS than penetrating trauma, and amputation was more frequent. In particular, patients with blunt trauma had significantly higher MESS than patients with penetrating trauma (8.2±2.2 vs. 5.8±1.3, respectively; p=0.005), and amputation was performed when revascularization failed in cases of blunt trauma of the lower extremity. Therefore, particular care is needed in making treatment decisions for patients with peripheral arterial injuries caused by blunt trauma.

Keyword

Blunt trauma; Penetrating trauma; Arteries; Revascularization