Trauma to the superficial femoral artery – Different etiologies, different surgical approaches

Abstract text (incl. references and figure legends)

The superficial femoral artery (SFA) is the most frequently injured vessel in lower limb traumas. It can be caused by a gunshot, blunt instrument, stab wounds and iatrogenic. We report two cases of traumatic lesions of the superficial femoral artery with two different etiologies and treatment approaches.

The first is a case of a male patient, 34 years old. He was at the intensive care unit for organophosphate poisoning needing plasmapheresis. He developed a pseudoaneurysm of the right superficial femoral artery with an associated hematoma after a dialysis catheter insertion. He was approached surgically with the identification of a puncture lesion of the SFA and was treated with arterial resection and end-to-end anastomosis.

The second is a case of a male patient, 21 years old, admitted to the emergency room after a penetrating trauma with a gunshot wound to the right leg. He presented hemodynamically unstable upon arrival, but with a good response to fluids and blood. After resuscitation, he had an angio-CT which showed a lesion of the SFA. He was taken to the operating room where a 2cm laceration with >50% of circumference was observed. After resection of the affected segment, a primary repair was done with the interposition of a prosthetic graft.

Both patients were discharged with good evolution and without complications.

Open surgical repair is usually the first treatment option for traumatic penetrating lesions such as gunshots and also other complications such as pseudoaneurysms. Our surgical strategy consisted of performing proximal and distal vascular control of the SFA with complete resection of the defect. The reconstruction technique decision is always based on local findings.

A. Gómez-Álvarez et al. Surgical treatment of a pseudoaneurysm of the femoral artery secondary to a gunshot wound. Clinical case report. Med Universit 2014

Mirenda.F et al.Gunshot injury of SFA. Surgical treatment without preoperative angiography:a case report. Chir Ital. 2006

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