Document Detail


Limb trauma with arterial injury: long-term performance of venous interposition grafts.
MedLine Citation:
PMID:  12730813     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: In contrast to arterial occlusive disease, data on long-term outcomes after vein grafts in limb trauma with arterial injury are sparse. PATIENTS: From 1991 through 2001, 22 trauma victims received 23 interposition vein grafts performed by an interdisciplinary team of trauma and vascular surgeons. Indications included both blunt and penetrating injuries with critical limb ischemia in the majority of cases. RESULTS: Operative treatment of the injured vessels (brachial n = 5, radial/ulnar n = 7, popliteal n = 6, tibial n = 3, pedal n = 2) encompassed venous interposition graft of either saphenous (n = 15) or cephalic vein (n = 8). All patients survived the operative procedure. 4 graft occlusions were noted and 3 major amputations had to be performed (one despite patent graft). 13 patients (76%) were available for duplex ultrasound examination after a mean follow-up of 59 months where patent grafts could be detected in all cases. CONCLUSION: A multidisciplinary approach ensures optimal treatment strategy of arterial injury in extremity trauma. Interposition vein grafts provide durable long-term results and should be attempted even in single-vessel injuries of forearm and lower leg.
Authors:
B Dorweiler; A Neufang; W Schmiedt; M H Hessmann; L Rudig; P M Rommens; H Oelert
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Publication Detail:
Type:  Evaluation Studies; Journal Article    
Journal Detail:
Title:  The Thoracic and cardiovascular surgeon     Volume:  51     ISSN:  0171-6425     ISO Abbreviation:  Thorac Cardiovasc Surg     Publication Date:  2003 Apr 
Date Detail:
Created Date:  2003-05-05     Completed Date:  2003-08-07     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7903387     Medline TA:  Thorac Cardiovasc Surg     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  67-72     Citation Subset:  IM    
Affiliation:
Department of Trauma Surgery, University Hospital, Mainz, Germany. dorweiler@htg.klinik.uni-mainz.de
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Anticoagulants / therapeutic use
Blood Flow Velocity / physiology
Brachial Artery / injuries,  physiopathology,  transplantation
Compartment Syndromes / diagnosis,  physiopathology,  therapy
Extremities / blood supply*,  injuries*
Female
Follow-Up Studies
Graft Occlusion, Vascular / drug therapy,  etiology,  mortality
Heparin / therapeutic use
Humans
Magnetic Resonance Angiography
Male
Middle Aged
Patient Compliance
Radial Artery / injuries,  physiopathology,  transplantation
Retrospective Studies
Saphenous Vein / injuries,  physiopathology,  transplantation
Severity of Illness Index
Survival Analysis
Time
Treatment Outcome
Ulnar Artery / injuries,  physiopathology,  transplantation
Ultrasonography, Doppler, Duplex
Vascular Patency / physiology
Vascular Surgical Procedures
Chemical
Reg. No./Substance:
0/Anticoagulants; 9005-49-6/Heparin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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