Our Surgical Experience in Peripheral Vascular Injuries: Retrospective Analysis of 45 Cases

Objective: We analyzed the cases who admitted to emergency due to peripheral vascular injuries (PVI) or any other causes and diagnosed with PVI, and operated by cardiovascular surgery clinic for their etiologies, accompanying lesions, Mangled Extremity Score System (MESS), surgical procedures, and results. Material and Methods: A total of 45 cases who admitted to emergency service due to PVI caused by different etiologies between January 2012 and July 2014 were evaluated retrospectively. Cases included in our study were seen in emergency service and were operated after they were diagnosed by physical examination. No further examinations were needed in order to diagnose PVI. Results: Sixty two vascular injuries were determined in 45 cases. There were 38 (84.4%) males. The most common etiology was stabbing (42.2%, n=19). Injuries were mostly in the upper extremities (%57.6, n=26). Ulnar artery was the most commonly injured vessel (%17.7, n=11) followed by posterior tibial artery (14.5%, n=9). Additional injuries were identified in 75.5% (n=34) of the cases. Tendon injuries were the most common ones (37.7%, n=17) among those additional injuries. Average MESS score of the patients was 4.15±2.03. The injured vessels were treated with end to end anastomosis (46.7%, n=29), primary repair (25.8%, n=16), and autogenous vein interposition (16.1%, n=10). Amputation was performed in one case (2.2%), and two cases (4.4%) died because of the accompanying body trauma. Conclusion: Location of injury, mechanism, presence of accompanying lesions and performing surgical procedure in time are important factors that determine mortality and morbidity. Especially in patients with multiple trauma, although vascular intervention had been performed, accompanying lesions can be decisive for mortality and morbidity. In these cases, close cooperation with other clinics is essential.