PMID- 34567854 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20210929 IS - 2168-8184 (Print) IS - 2168-8184 (Electronic) IS - 2168-8184 (Linking) VI - 13 IP - 8 DP - 2021 Aug TI - Outcomes of Revascularization and Factors Associated With Major Amputation in Patients With Lower Limb Arterial Injury: A Single-Center Retrospective Analysis. PG - e17290 LID - 10.7759/cureus.17290 [doi] LID - e17290 AB - Objective To identify the amputation rates and causative factors for failed revascularization leading to amputation in patients undergoing primary limb salvage procedures for lower-extremity vascular injuries. Methods This retrospective study was conducted at the vascular surgery department, Shaheed Mohtarma Benazir Bhutto (SMBB) Institute of Trauma, Karachi, Pakistan. The data were collected from hospital record using the non-probability sampling technique. Patients aged 17-70 years, undergoing primary revascularization during April 2016 to March 2021, were included in the study. Patients with crush injuries/non-salvageable limbs underwent primary amputation, isolated deep femoral artery or crural arteries (non-limb threatening) injuries, and non-traumatic injuries like intravenous drug-induced or iatrogenic injuries were excluded. The data analysis is done using SPSS Version 20.0 (IBM Corp., Armonk, NY, USA). A P-value of <0.05 was considered as significant. Results This study includes 56 patients of mean age 30.82 +/- 9.29 years with male gender four times more affected than their counterpart. About 32% of patients were smokers, while 58% of patients had no co-morbidities. All patients presented with a mean time of 7.66 +/- 1.69 hours of injury with an average of 1.14 arterial segments involved. The most frequent artery involved was popliteal artery (both above and below the knee), followed by superficial femoral artery injury constituting 50% and 26%, respectively, with arterial laceration and transection being common findings on exploration. Out of 56 patients, 27 (48.2%) had open fractures, 21 (37.5% ) closed fractures, and eight patients (14.3 % ) presented with dislocation as associated injuries. Following the procedure, secondary amputation was recorded in 18 (32.1%) patients. Thrombosis and infection were the leading causes of revascularization failure. Type of injury, segment of arterial injury, and associated bony injuries were associated with limb amputation. Conclusion Type and site of injury along with concomitant bony injuries are associated with major amputations after revascularization in lower-extremity arterial injuries. CI - Copyright (c) 2021, Ali et al. FAU - Ali, Ghulam AU - Ali G AD - Vascular Surgery, Shaheed Mohtarma Benazir Bhutto Institute of Trauma, Karachi, PAK. FAU - Berlas, Muhammad Fahad AU - Berlas MF AD - Vascular Surgery, Shaheed Mohtarma Benazir Bhutto Institute of Trauma, Karachi, PAK. FAU - Din, Najam U AU - Din NU AD - Vascular Surgery, Shaheed Mohtarma Benazir Bhutto Institute of Trauma, Karachi, PAK. FAU - Rehman, Khalil Ur AU - Rehman KU AD - Vascular Surgery, Shaheed Mohtarma Benazir Bhutto Institute of Trauma, Karachi, PAK. FAU - Muhammad Saleh, Waryam AU - Muhammad Saleh W AD - Vascular Surgery, Shaheed Mohtarma Benazir Bhutto Institute of Trauma, Karachi, PAK. FAU - Naqvi, Syed Arsalan Ahmed AU - Naqvi SAA AD - Internal Medicine, Dow University of Health Sciences, Karachi, PAK. LA - eng PT - Journal Article DEP - 20210818 PL - United States TA - Cureus JT - Cureus JID - 101596737 PMC - PMC8452226 OTO - NOTNLM OT - amputation OT - arterial injury OT - complex lower limb trauma OT - failed revascularization OT - limb salvage procedures OT - lower limb amputation OT - peripheral revascularization COIS- The authors have declared that no competing interests exist. EDAT- 2021/09/28 06:00 MHDA- 2021/09/28 06:01 PMCR- 2021/08/18 CRDT- 2021/09/27 06:13 PHST- 2021/08/18 00:00 [accepted] PHST- 2021/09/27 06:13 [entrez] PHST- 2021/09/28 06:00 [pubmed] PHST- 2021/09/28 06:01 [medline] PHST- 2021/08/18 00:00 [pmc-release] AID - 10.7759/cureus.17290 [doi] PST - epublish SO - Cureus. 2021 Aug 18;13(8):e17290. doi: 10.7759/cureus.17290. eCollection 2021 Aug.