Arterial Injuries in Extremities Trauma, Angiographic Findings

Abstract

At present, trauma is a common problem and regarded as the third cause of mortality in different societies. Significant part of injuries resulting from trauma is due to vascular damages. Tissue ischemia associated with vascular injuries is regarded as medical emergencies which can result in irretrievable ischemia if it continues for 6 h. Therefore, early diagnosis and quick treatment of vascular injuries are of high importance. In this cross sectional study, all trauma patients referred with possible vascular injury to angiography department of Tabriz Imam Khomeini Hospital from Apr. 2011 to Apr., 2012 underwent angiography. The results were compared with the similar studies conducted in other countries. Out of all patients, angiography detected vascular injury in 75 cases consisting of 93.7% of men and 5.3% of women. Motor vehicle (93.3%) especially motorcycles accidents were the most common cause of the damages. Leg was the most common site of trauma (62.2%) and associated fracture was seen in 86.7% of cases. Also, double fracture of leg was the most common associated fracture. Anterior tibial artery (36%) and complete arterial occlusion (62.7%) were the most common injured vessel and vascular injury, respectively. Vascular injuries are more common in young men (20-30 years old) mainly resulted from blunt trauma associated with motor vehicle especially motorcycle accidents. Leg and anterior tibial artery were introduced as the most common site and injured artery, respectively.

Risk of peripheral artery occlusive disease in patients with lower leg fracture who received fixation and non-fixation treatments: A population cohort study

“…However, whether this finding is true for artery compromise such as that in PAOD patients with lower leg fracture must be further investigated. Taken together, we believe that a high energy impact in lower leg comminuted fracture can not only damage bone alignment but also affect vessel patency [ 26 , 27 ]. Hence, patients with this condition should receive fixation treatment [ 28 ].…”

The Correlation between Lower Extremity Fracture and Subsequent Arterial Embolism and Thrombosis—A National Population Cohort Study

“…Although patients with lower leg fracture in the three age levels (<45, 40-64, and ≥65 years) had significant risks of SAET compared with the non-fracture group (Table 3), the underlying mechanism of injury may differ. Vascular injuries in the younger age after fracture were usually associated with motor vehicles, especially motorcycle accidents, in which the most common injured vessel and vascular injury was the anterior tibial artery (36%) and complete arterial occlusion (62.7%), respectively [5,21]. In contrast, the lowenergy fracture caused by a slip, trip, or fall from a standing pasture was the most common cause of lower-extremity fracture in the aged group [22].…”

“…Patients with vascular damage usually present with tibia-fibula, open and mid-shaft fractures [4]. The anterior tibial artery was the most commonly damaged vessel and manifested as complete arterial occlusion [5]. Artery insufficiency resulting from vessel damage may present either as acute limb ischemia or as non-union fracture or osteomyelitis in long-term follow-up [6,7].…”