Jayun Cho (Incheon / KR), Kang Kook Choi (Incheon / KR), Yangbin Jeon (Incheon / KR), Byungchul Yu (Incheon / KR), Gil Jae Lee (Incheon / KR), Jihun Gwak (Incheon / KR), Min A Lee (Incheon / KR), Se-Beom Jeon (Incheon / KR), Seung Hwan Lee (Incheon / KR), Sung Youl Hyun (Incheon / KR), Youngmin Kim (Incheon / KR), Youngeun Park (Incheon / KR), Jung Nam Lee (Incheon / KR)
Abstract text (incl. references and figure legends)
Background: Blunt peripheral artery injury may be seen as long injured arterial segment because of the injury mechanism of blunt trauma.
Methods: The survey was done for the patients with blunt peripheral arterial injury which was repaired by open surgery in a Level 1 trauma center from October 2019 to June 2022. After exploration and identification of the injured arterial segment, treatment decision was made. Primary repair/end-to-end anastomosis was done for the short injured arterial segment after resection with/without thrombectomy. Bypass surgery was done for the long injured arterial segment.
Results: After 1 patient was excluded due to no preoperative computed tomography angiography (pCTA), 22 patients were analyzed. Age was 48.7±16.0 year, and male patient was 95.5% (21/22). Injury severity score was 18.1±11.5. For the injured artery, there was 45.5% (10/22) femoral artery, 22.7% (5/22) popliteal artery, 13.6% (3/22) brachial artery, 9.0% (2/22) iliac artery, and 9.0% (2/22) tibial artery. Length of the injured arterial segment from open surgical repair (L-OSR) and length of the filling defect from pCTA were 2.3±1.1cm vs 7.3±5.0cm (p<0.001). L-OSR between primary repair/end-to-end anastomosis (77.3%, 17/22) and bypass surgery (22.7%, 5/22) was 1.85±0.8cm vs 3.6±0.9cm (p<0.001).
Conclusions: Primary repair can be used for the blunt peripheral artery injury given the tendency of short length of injured arterial segment despite the injury mechanism. Preoperative angiography findings such as long filling defect may mislead into either bypass surgery or endovascular intervention such as stent insertion.
References:
David V Feliciano, et al. Evaluation and management of peripheral vascular injury. J Trauma 2011 Jun;70(6):1551-6.2. Michael A Peck, et al. Management of blunt peripheral arterial injury. Vasc Surg Endovasc Ther 2006 Jun;18(2):159-73.
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