Popliteal artery trauma. Systemic anticoagulation and intraoperative thrombolysis improves limb salvage

Annals of Surgery
S M MeltonT C Fabian

Abstract

This study was conducted to evaluate those factors associated with popliteal artery injury that influence amputation, with emphasis placed on those that the surgeon can control. Generally accepted factors impacting amputation after popliteal artery injury include blunt trauma, prolonged ischemic times, musculoskeletal injuries, and venous disruption. Amputation ultimately results from microvascular thrombosis and subsequent tissue necrosis, predisposed by the paucity of collaterals around the knee. Patients with popliteal artery injuries over the 10-year period ending November 1995 were identified from the trauma registry. Preoperative (demographics, mechanism and severity of injury, vascular examination, ischemic times) and operative (methods of arterial repair, venous repair-ligation, anticoagulation-thrombolytic therapy, fasciotomy) variables were studied. Severity of extremity injury was quantitated by the Mangled Extremity Severity Score (MESS). Amputations were classified as primary (no attempt at vascular repair) or secondary (after vascular repair). After univariate analysis, logistic regression analysis was performed to identify the independent risk factors for limb loss. One hundred two patients were identified; 88 (8...Continue Reading

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Citations

Oct 8, 2014·Plastic and Reconstructive Surgery. Global Open·Yuki IijimaEiji Kobayashi
Oct 30, 2004·The Journal of Trauma·Bradford Glenn Scott, Asher Hirshberg
Sep 24, 2005·ANZ Journal of Surgery·Mazri M YahyaKishore Sieunarine
Sep 26, 2009·Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA·Gregg T NicandriChristopher J Wahl
Dec 1, 2013·European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society·M J MartinJ A Asensio
Aug 1, 2012·European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society·J D SciarrettaJuan A Asensio-Gonzalez
Feb 19, 2020·European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society·Shujhat KhanMansoor Khan
Jan 19, 2017·The Journal of Trauma and Acute Care Surgery·Zoё MaherMark J Seamon
Feb 1, 2011·European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society·J F C de VasconcelosA G Vaz
Aug 12, 2009·The Journal of Trauma·Rachael A CallcutMatthew W Mell
Jun 1, 2012·European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society·A F GarcíaJ C Puyana
Oct 31, 2013·Annals of Surgery·Mohammad R Rasouli
Jan 28, 2021·The Journal of Trauma and Acute Care Surgery·Matthew KochubaDavid Feliciano
Apr 6, 2017·Injury·Melissa N LojaUNKNOWN AAST PROOVIT Study Group
Feb 28, 2021·Journal of Vascular Surgery·Leigh Ann O'BanionGregory A Magee

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