ABSTRACT

Penetrating vascular injuries are medical conditions that we often come across and require urgent treatment. Early diagnosis and treatment play a big role reducing the mortality and morbidity in patients suffering from penetrating vascular injuries.

We retrospectively observed 168 patients who were operated by us between January 2016 and September 2019 because of peripheral vascular injuries. Demographic features, clinical findings at diagnosis and follow-up and 3rd month arterial duplex ultrasound (DUS) findings were evaluated.

In our study, 244 vascular structures were repaired in 168 patients. The most commonly injured vascular structure was femoral artery in 54 (22%) cases. Other injured vascular structures were radial artery in 47 (19%), superficial femoral vein in 33 (14%), deep femoral vein in 28 (11%), ulnar artery in 23 (9%), brachial artery in 21 (9%), popliteal artery in 12 (5%), posterior tibial artery in 9 (4%) and the anterior tibial artery in 3 (1%) cases When it comes to surgical techniques, while primary repair was performed in 57 (23%), and end-to-end anastomosis in 92 patients (38%). As a graft material saphenous vein was used in 60 (25%) and PTFE (polytetraflorethylene) in 35 patients (14%). Two patients (1.19%) with femoral artery repair had suffered from compartment syndrome and fasciotomy had to be done. In a patient with bone fracture accompanied to vascular injury, amputation was performed by the orthopedic clinic due to severe osteomyelitis and necrosis after discharge. At follow-up control after 3 months, stenosis above 70% was not detected with arterial duplex ultrasound (DUS) in any patient and no intervention was required.

Immediate arrival of patients with penetrating injuries to the hospitals and approach to the patient in consideration of vascular injury in the emergency rooms are significantly important in reducing limb loss and mortality.

Keywords: peripheral vessel, vascular injury, penetrating injury