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• W2982160062 abstract "Most traumatic lower extremity vascular injuries are located in the groin and upper thigh, involving the superficial femoral artery and common femoral artery. There is a scarcity of data regarding below-knee (BK) penetrating vascular trauma. In this study, we report our level I trauma center experience with post-traumatic BK vascular repairs (Jerusalem, Israel). We stratify our data on the basis of the mechanism of injury and repair as well as the need for fasciotomy, concomitant venous repair, limb salvage, and recommendations on discharge. Between 2016 and 2018, our trauma center operated on a total of 26 male patients with a mean age of 31 years presenting with BK vascular injuries. This constitutes 26 of 45 (58%) cases of lower extremity vascular trauma at our institution. All patients underwent open repair. The mechanism of injury was classified as blunt in 11 (42%) and high-velocity penetrating projectiles in 15 (58%). This unusual distribution is probably due to Jerusalem’s being an epicenter of the Middle East conflict. Fasciotomies were performed in 14 of 26 (54%) patients at the initial surgery because of a propensity for the development of compartment syndrome. Repair of the popliteal vein was necessary in 5 of 26 (19%) patients, which was performed with great saphenous vein in 3 patients and small saphenous vein and basilic vein in 1 patient each. The conduit of choice was the contralateral great saphenous vein in 19 patients (73%), primary repair and small saphenous vein in 1 patient each, and synthetic graft in 2 patients. All but three patients underwent preoperative computed tomography angiography (89%), and five (19%) underwent intraoperative angiography. A pedal pulse was palpable postoperatively in 21 (81%) patients, and 19 (73%) were discharged with aspirin (100 mg/d) treatment, 4 on full anticoagulation (15%). A total of 21 (81%) limbs were salvaged, with 5 (19%) undergoing amputation below or above the knee because of overwhelming postoperative infection. It was noted that four of five (80%) limb losses coincided with nonpalpable pulse postoperatively. BK vascular injury is an uncommon but complicated entity of vascular surgery in which postoperative outcome is determined by prompt vascular repair, especially before orthopedic intervention. The delayed intervention necessitates fasciotomies, with infectious complications and higher rates of limb loss." @default.
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• W2982160062 date "2019-11-01" @default.
• W2982160062 modified "2023-09-25" @default.
• W2982160062 title "LEA 22. Below-Knee Popliteal Vascular Injuries (The Jerusalem Experience)" @default.
• W2982160062 doi "https://doi.org/10.1016/j.jvs.2019.08.039" @default.
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