Acute Trauma of the Femoral Artery and Vein


    loading  Checking for direct PDF access through Ovid

Abstract

Between 1974 and 1991, 233 patients were treated for 321 confirmed femoral vascular injuries. There were 112 patients (48%) with isolated arterial injuries, 36 (15%) with isolated venous injuries and 85 (36%) with combined arterial and venous injuries. Injury to the concomitant superficial or common vessels occurred in 27 (8.3%) and 9 (1.7%) patients, respectively. Associated extremity injuries included bone, 15% soft tissue and muscle, 11% and nerve, 7%. Sixty patients (26%) had fasciotomies. Arterial thrombosis occurred in five superficial repairs. Eighteen repaired veins thrombosed—eight of 61 simple (lateral venorrhaphy) and ten of 50 complex repairs. Thirty-four percent of patients with a repaired venous injury had clinical evidence of postoperative venous morbidity—deep vein thrombosis (DVT), edema, pulmonary embolus. Six patients (2.5%) had a documented pulmonary embolus—four in the 18 patients (22%) with clotted venous repairs. Eleven patients (4.7%) underwent an amputation. Five of the amputations were in patients with either inadequate or delayed fasciotomy. An inadequate fasciotomy was equally as deleterious as a delayed fasciotomy in terms of outcome. Six of 27 limbs (22%) with a femur fracture required an amputation. There were six deaths. Acute limb morbidity was related to the extent of associated limb trauma, i.e., soft-tissue, nerve, and bone damage. Chronic morbidity was related to neurologic deficits and venous sequelae. Vascular injury to the femoral vessels was associated with a high morbidity but low mortality.

    loading  Loading Related Articles