ISOLATED RADIAL OR ULNAR ARTERY LACERATION-ANASTOMOSIS OR LIGATION: A SURGICAL DILEMMA

Background : Due ta the diversity of patency rates reported in the literature the surgical management of isolated radial ar ulnar artery laceration remains stili controversial. The philosophy of our department is repairing the lacerated artery in such injuries. The aim of this study is to evaluate the midterm patency results of our operations performed ta radial ar ulnar artery laceration.

Patlents and Methods: This study includes 24 patienıs who underwent arterial reconstruction far isolated radial ar ulnar artery laceration between June 1999 and June 2002 at Trakya University Medical Faculty Department of Cardiovascular Surgery. The hospitalization records and operative logs were retrospectively reviewed in order ta obtain patient demographics. The patency of repaired arteries was evaluated via color doppler ultrasonography, and hand functions evaluated during postoperative visits.

Results : There were 23 males and 1 female with a mean age of 26.9 ± 10.3 (3 ta 52 years). Twenty-one of the patients had self-inflicted glass wounds on their forearms. Three patients were victims of traffic ar home accidents. Nine patients had only arterial laceration while 15 patients had additional nerve and tendon injuries. Eighteen patients (75 %) returned tor follow-up. The mean follow-up period was 10.1 ± 4.8 months (1 to 18 months). The patency rate was tound 77 % (n:14) in color doppler examination. Hand functions were normal in patients who had only arterial laceration. Neuropathic symptoms (such as claudication, cold intolerance, paresthesia and hand weakness ) were detected in patients with additional nevre and tenden injury.

Conclusion: Because of the variation of patency rates, every department has determined its own private policy tor the isolated radial or ulnar artery injury. Contrary to some reports, we conclude that the repair ot injured forearm arteries may have greater benefits than ligation, such as (1) the preservation ot native arterial anatomy that will serve asa cannulation site, inflow tor the arteriovenous fistula ora conduit tor bypasses, (2) the prevention of hand ischemia from similar injuries in future, and (3) serving as an opportunity lor residency training.