Popliteal artery trauma. A critical appraisal of an uncommon injury.
Although popliteal artery injuries are uncommon, the consequent lack of management protocols may contribute to an already high level of outcome morbidity. We critically reviewed all nine cases of popliteal artery trauma treated at our institution in the last 5 years. The main findings were that blunt trauma was predominant and most patients presented with severe signs of ischaemia. Long delays occurred between injury and treatment, mostly due to the tyranny of distance. Nevertheless, most patients were subjected to further delay whilst undergoing unnecessary formal angiography. Interposition vein graft using contralateral long saphenous vein was the predominant procedure for arterial injury. Most patients did not receive systemic anticoagulation or fasciotomy, and none received intra-operative thrombolysis. Our limb salvage rate was 7/9, although two of these had persistent neurological disability. We criticise our shortcomings in the light of the current literature.
Gupta
R
R
Department of General Surgery, Royal Perth Hospital, Wellington Street Campus, Box X2213 GPO, Perth, WA 6847, Australia. robin.gupta@netscapeonline.co.uk
Quinn
P
P
Rao
S
S
Sleunarine
K
K
D000293:Adolescent; D000328:Adult; D000792:Angiography / Q000706:statistics & numerical data; D000925:Anticoagulants / Q000627:therapeutic use; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D011150:Popliteal Artery / Q000000981:diagnostic imaging / Q000293:injuries*; D012189:Retrospective Studies; D012501:Saphenous Vein / Q000637:transplantation; D013997:Time Factors; D016896:Treatment Outcome; D019564:Unnecessary Procedures; D014949:Wounds, Nonpenetrating / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*
D000925:Anticoagulants