Management of popliteal artery injuries Popliteal arter yaralanmalarinin tedavisi

Aim. Peripheral vascular injuries constitute a major problem in cardiovascular surgery. Popliteal artery injuries account for between 5 and 19% of extremity arterial injuries. Despite improvements in surgical techniques of peripheral vascular injuries, a high amputation risk is still seen. The aim of this study was to review our experience in the management of popliteal artery injuries. Method. We studied retrospectively a number of 41 patients with popliteal artery injuries in our department between May 1999 and March 2009. Injuries were related to stab wound in 11 patients, gunshots in 23, and blunt trauma in 7. Primary vascular repair was preferred where possible; if not possible the interposition graft was used. Result. The study group consisted of 33 males and 8 females, ranging in age from 18 years to 56 years with a mean age of 28.1±6.4 years. Penetrating trauma was the cause of a high proportion of cases. Arterial repair techniques performed were end-to-end anastomosis in 21 popliteal arterial injuries, saphenous vein graft interposition in 13, lateral arteriorrhaphy in 4, ringed PTFE graft interposition in 2, and patch plasty in 1. There were 19 patients with associated popliteal vein injury, of which 5 cases had end-to-end anastomosis, 7 had lateral venorrhaphy, 6 had vein graft interposition, and 1 had PTFE graft interposition. Conclusion. Although prompt arterial repair appears to be a critical factor that improves the extremity salvage rate, even in popliteal arterial injury with complete motor deficit without mottling, vascular repair should be considered regardless of ischemic time.