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Thorac Cardiovasc Surg 2003; 51(2): 67-72
DOI: 10.1055/s-2003-38986
Original Cardiovascular
© Georg Thieme Verlag Stuttgart · New York

Limb Trauma with Arterial Injury: Long-term Performance of Venous Interposition Grafts

B.  Dorweiler1, 2 , A.  Neufang2 , W.  Schmiedt2 , M.  H.  Hessmann1 , L.  Rudig1 , P.  M.  Rommens1 , H.  Oelert2
  • 1Department of Trauma Surgery, University Hospital, Mainz, Germany
  • 2Department of Cardiothoracic and Vascular Surgery, University Hospital, Mainz, Germany
Further Information

Publication History

Received: December 15, 2002

Publication Date:
05 May 2003 (online)

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Abstract

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.

Key words

Vein graft - arterial injury - limb trauma

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Bernhard Dorweiler MD 

Department of Cardiothoracic and Vascular Surgery, University Hospital

Langenbeckstraße 1

55131 Mainz

Germany

Phone: +49/6131/173208

Fax: +496131/173626

Email: dorweiler@htg.klinik.uni-mainz.de

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