ABSTRACT
BACKGROUND: Popliteal artery injuries are uncommon and often result in limb loss or long-term limb dysfunction. The aims of this study were (1) to evaluate the association between predictors and outcomes and (2) to validate the rational of systematic early fasciotomy. METHODS: This retrospective cohort study included 122 patients (80% men, n = 100) who underwent surgery for popliteal artery injuries from October 2018 to March 2021 in southern Vietnam. Primary outcomes included primary and secondary amputation. The associations between predictors and primary amputation were analyzed using logistic regression models. RESULTS: Among the 122 patients, 11 (9%) underwent primary amputation, while 2 (1.6%) had secondary amputation. Longer time to surgery was associated with increased odds of amputation (odds ratio = 1.65; 95% confidence interval, 1.2 to 2.2 for every 6 hr). Severe limb ischemia was also associated with a 50-fold increase in the risk of primary amputation (adjusted odds ratio = 49.9; 95% confidence interval, 6 to 418, P = 0.001). Furthermore, 11 patients (9%) without signs of severe limb ischemia and acute compartment syndrome on admission were found to have myonecrosis of at least one muscle compartment during fasciotomy. CONCLUSIONS: The data suggest that among patients with popliteal artery injuries, prolonged time before surgery and severe limb ischemia are associated with increased risk of primary amputation, whereas early fasciotomy may lead to improved outcomes.
Subject(s)
Popliteal Artery , Vascular System Injuries , Male , Humans , Female , Popliteal Artery/diagnostic imaging , Popliteal Artery/surgery , Popliteal Artery/injuries , Fasciotomy/adverse effects , Retrospective Studies , Treatment Outcome , Vascular System Injuries/diagnostic imaging , Vascular System Injuries/etiology , Vascular System Injuries/surgery , Ischemia/diagnostic imaging , Ischemia/surgeryABSTRACT
Description of the use of the left renal vein for aortic reconstruction in primary aortoenteric fistula secondary to a mycotic aneurysm has not been found in the literature. We report here a case of primary aortoenteric fistula secondary to a mycotic aneurysm with gross retroperitoneal contamination that was successfully treated by using a left renal vein graft for aortic reconstruction.
