Peripheral Arterial Injuries with Gunshot Wounds: Surgical Treatments and Results

Abstract

Between 1975 and 1985, 102 consecutive patients with 106 peripheral vascu lar injuries caused by gunshot blasts were treated in the authors' clinic. The average age was 25.6 ± 11.4 (mean ± SD). The average time between arterial injury and arrival to the hospital was 13.2 ± 4.8 hours. Sixty-six (62.3%) arte rial injuries were found in lower extremities and the most commonly injured artery was the superficial femoral artery. Thirty-six (35.3%) patients had com bined arterial and venous trauma. All patients with vascular involvement had some signs and symptoms of vascular trauma. Preoperative angiography was required in 23 cases and demonstrated arterial injury; 98 patients underwent surgical intervention. Resection of the injured arterial segment and end-to-end anastomosis were done in 44 patients. Resection of the arterial segment followed by interposition of autogenous vein graft was done in 34 patients. One case underwent nonbiologic graft (Dacron) replacement (in the left subclavicular ar tery). Primary lateral suture was placed in 6 cases, and ligation was made in 9. In cases associated with venous injury, 22 vascular venous repairs and 14 liga tions were done. Eighty-one (79.4%) patients retained a functional limb. Two cases underwent primary amputation, and 9 cases underwent secondary ampu tation. Six patients died; the causes of morbidity were usually related to associ ated injuries. Four patients refused the surgical approach.