Peripheral vascular injuries: diagnosis, management, out come, and review of risk Factors

ABSTRACT

The aim of this study is to retrospectively analyse our data regarding patients with vascular injuries admitted to Al-Noor hospital, reviewing the diagnosis, management, outcomes and identifying the risk factors associated with limb loss. Between November 2003 and January 2006, prospectively collected data for 152 patients with vascular injuries were reviewed and analysed retrospectively. The data were obtained from data base of all the hospital admissions. 88 [57.9%] patients were due to blunt trauma. In 52 [34.2%] patients the injury was due to penetrating wounds and 12 [7.3%] patients sustained firearm injuries. The upper limb was affected in 68 [44.7%] patients, lower limb in 65 [42.8%] patients, neck in 12 [7.9%] patients and pelvis in 7 [4.6%] patients. 151 arterial injuries and 28 venous injuries. Brachial artery was the most common type of injury, 36 [20.1%] of the injuries, 29 [16.2%] popliteal artery injuries, superficial femoral artery injuries were 14 [7.8%'], and 14 [7.8%] were ulnar artery injuries. 80 patients had associated fractures and dislocations. Supracondylar fracture of the numerous was the commonest [28]. Extensive soft tissue injury and open fracture were present in 30 patients, 65 of the arterial injuries were managed by vein graft repair. 62 fasciotomies were done, 50 for lower limb and 12 for upper limb injuries. 5 of our patients with combined musculoskeletal and vascular injuries of the lower limb underwent primary vascular shunt insertion, 5 arteries and 2 veins. We had 12 patients underwent amputation and 3 patients died during their hospitalisation. Blunt trauma is more serious than penetrating injuries. The most significant risk factor for limb loss was failure of revascularization