Missile vascular injuries: 19-year experience.
BACKGROUND
Missile vascular injuries have reached an epidemic proportion in Kashmir valley since the eruption of militancy. The present study was undertaken to analyze the mode, pattern, presentation, and management of missile vascular injuries.


METHODS
A retrospective study of patients with missile vascular injury from January 1990 to October 2008 was undertaken. Five hundred eighty patients with missile vascular injury were studied. All patients with vascular injury due to causes other than missiles were excluded from the study.


RESULTS
Most of the patients were treated by interpositional saphenous vein graft or end-to-end anastomosis. The most common complication was wound infection (22.7%) followed by graft occlusion (3.8%). The amputation rate was 3.3% and was higher in patients with a delay of >6 hours to revascularization and associated fractures.


CONCLUSIONS
Missile vascular injury requires prompt resuscitation and revascularization. Preoperative angiography is seldom necessary. Doppler study may sometimes be needed to aid in the diagnosis.
Sheri-Kashmir Institute of Medical Sciences Soura Srinager, India. latifs_dr@yahoo.com
Abdul Gani
AG
Ahanger
Mohd Lateef
ML
Wani
Reyaz Ahmad
RA
Lone
Shyam
S
Singh
Zahur
Z
Hussain
Ishtiyak A
IA
Mir
Ifat
I
Irshad
Hakeem Zubair
HZ
Ashraf
Abdul Majeed
AM
Dar
Ghulam Nabi
GN
Lone
Mohammad Akbar
MA
Bhat
Mukand Lal
ML
Sharma
D001158:Arteries / Q000293:injuries*; D001808:Blood Vessels / Q000293:injuries*; D003288:Contusions / Q000453:epidemiology; D006801:Humans; D008887:Military Medicine; D012189:Retrospective Studies; D014421:Turkey; D014652:Vascular Diseases / Q000097:blood / Q000453:epidemiology / Q000209:etiology / Q000601:surgery*; D014754:Violence; D014857:Warfare; D014950:Wounds, Penetrating / Q000097:blood / Q000453:epidemiology / Q000601:surgery*