Femoral vessel injuries; high mortality and low morbidity injuries

Abstract

Femoral vessel injuries are amongst the most common vascular injuries admited in busy trauma centers. The evolution of violence and the increase in penetrating trauma from the urban battlefields of city streets has raised the incidence of femoral vessel injuries, which account for approximately 70% of all peripheral vascular injuries. Despite the relatively low mortality associated with these injuries, there is a high level of technical complexity required for the performance of these repairs. Similarly, they incur low mortality but are associated with significantly high morbidity. Prompt diagnosis and treatment are the keys to successful outcomes with the main goals of managing ischemia time, restoring limb perfusion, accomplishing limb salvage and instituting rehabilitation as soon as possible.

Management of Femoral Vessel Injuries: A 6-year Single-center Experience

“…Femoral vessels, in particular, are the most common sites for vascular injury and comprise nearly 70 per cent of all arterial traumas. [1][2][3] Over the past two decades, firearms still remain the most common mechanism of FVI at our institution. 10 In this series, 84 per cent of FVIs resulted from penetrating mechanism; 90 per cent of these were from GSWs and is representative of prior publications.…”

“…10 In this series, 84 per cent of FVIs resulted from penetrating mechanism; 90 per cent of these were from GSWs and is representative of prior publications. [1][2][3][4][5]10 Blunt arterial injuries are typically the consequence of shearing force or stretch and are the result of contusion or crush injuries. The effects of focal intimal damage can lead to pseudoaneurysm, dissection, and thrombosis.…”

“…A detailed physical examination, ABI less than 0.9, and the presence of ''soft signs'' may warrant further investigation by CTA or conventional angiography. [1][2][3][15][16][17] CTA has been proven to be safe, immediate, and effective in the diagnoses of LEVI; however, conventional preoperative angiography can be used when CTA is indeterminate in hemodynamically stable patients. 18,19 Seamon et al 18 reported 100 per cent sensitivity and specificity by using CTA for detection of extremity vascular injury.…”

“…F EMORAL VESSEL INJURIES (FVIs) account for approximately 70 per cent of all peripheral vascular injuries in a busy metropolitan trauma center. [1][2][3] Multiple single-center reviews demonstrate penetrating mechanisms as the leading cause of these injuries. The reported mortality rate associated with FVI is 2.6 to 9.4 per cent.…”