Contemporary outcomes of traumatic popliteal artery injury repair from the popliteal scoring assessment for vascular extremity injury in trauma study

O’Banion, Leigh Ann; Dirks, Rachel; Saldana-Ruiz, Nallely; Farooqui, Emaad; Yoon, William; Pozolo, Cara G.; Fox, Charles J.; Crally, Alexis; Siada, Sammy; Nehler, Mark R.; Brooke, Benjamin S.; Beckstrom, Julie; Kiang, Sharon C.; Boggs, Hans K.; Chandra, Venita; Ho, Vy T.; Wei, Zhou; Lee, Ashton; Bowens, Nina; Cho, Yan; Woo, Karen; Ulloa, Jesus G.; Magee, Gregory A.

doi:10.1016/j.jvs.2021.04.064

Cited by 12 publications

(6 citation statements)

References 21 publications

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“…There wasn't any significant difference in amputation rate between the two groups that is similar with but Dua et al identified that blunt injury combined with fractures and an ISS (Injury Severity Score) > 9 is associated the risk of amputation, whereas in a military group, Penetrating injuries due to explosive devices are associated with worse functional outcome and a higher amputation (24). Obniaon et al (15) showed that amputation risk is higher in blunt popliteal injury compromised with penetrating group which is similar with results of The results showed that there was no significant association between patients' BMI and amputation rate, which was inconsistent with the study of Simmons et al They showed that BMI in the blunt trauma group is significantly higher than the penetrating group. The prevalence of obesity is increasing in Iran.…”

Section: Resultsmentioning

confidence: 73%

“…The difference in outcomes of blunt and penetrating popliteal artery trauma is an issue that has always been of investigating by vascular surgeries (11)(12)(13)(14). The results of Banion et.al showed that there is no difference between the outcome of popliteal artery injury due to blunt and penetrating trauma (15). The results of Zhong et.al showed that technical success rate of endovascular repair of blunt popliteal arterial injuries was 100% (16).…”

Section: Introductionmentioning

confidence: 99%

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Comparison the outcomes of blunt trauma with penetrating traumatic popliteal artery injury repair in Southwest of Iran

Azadvar,

Mousavi,

Tork

et al. 2023

Preprint

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Background: Popliteal artery injuries (PAIs) are one of the most severe peripheral vascular damages that may lead to movement impairment or amputation. This study aimed to compare the repair results of PAIs due to blunt and penetrating trauma in patients referred to the Vascular Surgery Center in the southwest of Iran. Methods: In this case-control study that conducted on patients with vascular trauma referred to the southwest trauma center of Iran in 2020; case group included patients with blunt trauma and control group compromised patients with penetrating trauma. The sampling method was census. The data collection tool was a checklist containing demographic information, medical information, vascular information, Functional Independence Measure (FIM) Score, and Mangled Extremity Severity Score (MESS). The chi-square test, Fisher exact test, and independent t test were used for comparison of categorical and quantitative data between case and control groups. Statistical analyses were conducted using SPSS version 24. Significance level considered p-value less than 0.05. Results: In this study from 92 participants, 63.1% of them (58 people) had blunt trauma (case group); The mean age of participants in the case group was 45.37 - 9.14 and in the control group was 49.43 - 10.65. 64.7 % of participants in the case group and 67.2 in the control group were male. The mean GCS of participants in the case group was 10.80 - 1.30 and in the control group was 11.72 - 0.70. 10.6% of participants needed limb fasciotomy (1.7% in the case group and 26.3% in the control group). The amputation rate was 12% in the case group and 8.8% in the control group. There was a significant difference between the two groups in terms of organ fasciotomy (P = 0.035), type of PAI (P = 0.018), and fracture (P = 0.007). MESS (P < 0.001), FIM Score (P < 0.001), time of discharge (P < 0.001), and arterial condition (P < 0.001). Conclusions: The results showed that the complications of penetrating PAI included organ fasciotomy (type of fracture, MESS, FIM Score, time of discharge, and arterial condition) in the southwest of Iran and were significantly more than the blunt type. More studies are needed with a larger sample size and extended duration. Keywords: Blunt Trauma, Penetrating Trauma, Popliteal Artery, Vascular Surgery

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Section: Resultsmentioning

confidence: 73%

Section: Introductionmentioning

confidence: 99%

Comparison the outcomes of blunt trauma with penetrating traumatic popliteal artery injury repair in Southwest of Iran

Azadvar,

Mousavi,

Tork

et al. 2023

Preprint

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“…While discharge on antithrombotic therapy is a variable identified within the PROOVIT database, the use of in-hospital antithrombotic therapy that may have impacted the outcome of in-hospital stroke and in-hospital stroke/death was poorly recorded. As data on antiplatelet therapy continue to evolve, its ability to provide protection across all vascular beds appears to be evident with minimal associated risk of bleeding complications 20,21 . Based on current data, initiation of postinjury antiplatelet therapy and continuation upon discharge, regardless of treatment or type of injury is advisable.…”

Section: Discussionmentioning

confidence: 99%

“…As data on antiplatelet therapy continue to evolve, its ability to provide protection across all vascular beds appears to be evident with minimal associated risk of bleeding complications. 20,21 Based on current data, initiation of postinjury antiplatelet therapy and continuation upon discharge, regardless of treatment or type of injury is advisable.…”

Section: Discussionmentioning

confidence: 99%

Risk factors for stroke in penetrating carotid trauma—An analysis from the PROOVIT Registry

O’Banion

Dirks

Siada

et al. 2022

J Trauma Acute Care Surg

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BACKGROUND:Penetrating carotid injuries are associated with an up to 20% risk of stroke. This study evaluated patients in the American Association for Surgery of Trauma PROspective Observational Vascular Injury Trial, with the aim of determining factors associated with stroke and stroke or death. METHODS:Penetrating extracranial carotid injuries in the American Association for Surgery of Trauma PROspective Observational Vascular Injury Trial registry from 2012 to 2020 were queried. Isolated external carotid injuries were excluded. Patients with documented postinjury in-hospital stroke were compared with those without. Significant predictors ( p < 0.1) for stroke and stroke or death on univariate analysis were included in multivariate analyses. RESULTS:One hundred two patients from 17 institutions were included. Mean age was 35 ± 18 years, and 80% were male. Average Glasgow Coma Scale (GCS) score on presentation was 9 ± 5, with an Injury Severity Score [ISS] of 22 ± 13. Operative management occurred in 51% of patients who were significantly more hypotensive (systolic blood pressure: 109 vs. 131 mm Hg; p = 0.015) with a lower initial pH (7.17 vs. 7.31; p = 0.001) and presented with hard signs of vascular injury (74% vs. 26%; p < 0.001). Overall stroke rate was 17% (23% operative vs. 10% nonoperative, p = 0.076). Rate of stroke or death was 27% (64% operative and 36% nonoperative). On multivariate analysis, lower GCS ( p = 0.05) and completion angiography ( p = 0.04) were associated with stroke. Likewise lower GCS ( p = 0.015) and ISS ( p = 0.04) were associated with stroke or death. CONCLUSION:Penetrating carotid trauma undergoing operative management had a stroke rate of 23%. Low GCS on arrival and need for completion angiography are independently associated with postinjury in-hospital stroke, whereas low GCS on arrival and ISS were associated with stroke or death. The ideal treatment strategy remains elusive, thus a dedicated multicenter study may help to achieve higher fidelity data on this rare but devastating injury.

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“…Open traumatic lesion of the popliteal artery is relatively rare, being associated with a high risk of limb loss, with an amputation rate ranging from 10% to 16% [1,2]. Ischemia time longer than 6 h and severity of limb ischemia have been shown to be associated with an increased risk of limb loss [1,3].…”

Section: Introductionmentioning

confidence: 99%

Limb Salvage after Lower-Leg Fracture and Popliteal Artery Transection—The Role of Vessel-First Strategy and Bone Fixation Using the Ilizarov External Fixator Device: A Case Report

et al. 2021

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Open traumatic lesion of the popliteal artery is relatively rare. Ischemia time longer than 6 h and severity of limb ischemia have been shown to be associated with an increased risk of limb loss. Severe local infection is critical in the presence of major soft tissue trauma or open fractures. We report the case of a young female who suffered a traumatic transection of the popliteal artery associated with an open fracture of the distal tibia and fibula managed by direct vessel reconstruction with an end-to-end repair and skeletal stabilization initially with half-pin external fixation, then replaced by an Ilizarov circular frame. The patient had a very satisfactory outcome, but the fracture healed malunited, later corrected by open reduction and internal fixation with lag-screwing and a neutralization plate.

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Contemporary outcomes of traumatic popliteal artery injury repair from the popliteal scoring assessment for vascular extremity injury in trauma study

Cited by 12 publications

References 21 publications

Comparison the outcomes of blunt trauma with penetrating traumatic popliteal artery injury repair in Southwest of Iran

Comparison the outcomes of blunt trauma with penetrating traumatic popliteal artery injury repair in Southwest of Iran

Risk factors for stroke in penetrating carotid trauma—An analysis from the PROOVIT Registry

Limb Salvage after Lower-Leg Fracture and Popliteal Artery Transection—The Role of Vessel-First Strategy and Bone Fixation Using the Ilizarov External Fixator Device: A Case Report

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