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Five-year outcomes after bypass graft versus Fogarty balloon catheter for the treatment of acute blunt popliteal artery injury

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European Journal of Trauma and Emergency Surgery Aims and scope Submit manuscript

Abstract

Purpose

To evaluate long-term clinical outcomes after revascularization by bypass graft versus Fogarty balloon catheter in acute blunt popliteal artery injury and identify risk factors contributing to amputation.

Methods

A retrospective review was conducted in patients treated for acute blunt PAI between 2011 and 2019. Inclusion criteria were patients who underwent bypass graft and Fogarty balloon catheter. The cumulative limb salvage rate was calculated by the Kaplan–Meier test and compared with Breslow–Wilcoxon test. Cox proportional hazard model was performed to estimate the potential risk factors for amputation. Receiver operating characteristic (ROC) curve was used to determine the optimal cut-off value for the potential risk factors.

Results

The overall limb salvage rate was 60.4% (29/48), including 24 patients (66.7%) in bypass graft, and 5 patients (41.7%) in Fogarty balloon catheter with mean follow-up of 5 years (range, 2–10 years). Among amputees, 15 patients (15/19, 78.9%) received primary amputation due to vascular failure or severe soft tissue damage, and 4 received secondary amputation because of chronic bone infection or neurologic deficit. Kaplan–Meier curves showed patients who received Fogarty balloon catheter had significantly higher amputation rate than those received bypass graft, with a hazard ratio of 3.801 (95% CI: 1.162–12.43, p = 0.009). In addition, Cox proportional hazard model revealed that MESS was the only independent risk factor for patients developing amputation, and the optimal cut-off value of MESS was 8.

Conclusion

Five-year outcome demonstrated that Fogarty balloon catheter is not a safe procedure and has significantly higher amputation rate in severe blunt PAI. MESS is the only risk factor for amputation.

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Data availability statement

All the data will be available upon request to the corresponding author of the present paper.

Abbreviations

PAI:

Popliteal artery injury

MESS:

Mangled extremity severity score

ROC:

Receiver operating characteristic

AUC:

Area under curve

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Funding

No funds, grants, or other support was received.

Author information

Author notes

  1. Gang Liu and Lin Li are co-first authors and contributed equally to this study.

Authors and Affiliations

  1. Department of Orthopaedics, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, No.12 Changjia Lane, Fucheng District, Mianyang, Sichuan Province, 621000, People’s Republic of China

    Gang Liu, Lin Li, Han Xu & Bin Kang

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  1. Gang Liu
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  2. Lin Li
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Contributions

GL and LL participated in draft writing, data collection, patients’ follow-up and data analysis. HX participated in data collection, patients’ follow-up and data analysis. BK designed the research and revised the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Bin Kang.

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Conflict of interest

Gang Liu, Lin Li, Han Xu and Bin Kang declare that they have no conflict of interest.

Ethical approval

The study was approved by the Ethics Committee on Biomedical Research, Mianyang Central Hospital and was done in accordance with the Declaration of Helsinki.

Consent to participate

All patients gave their informed consent prior to their inclusion in the study.

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Liu, G., Li, L., Xu, H. et al. Five-year outcomes after bypass graft versus Fogarty balloon catheter for the treatment of acute blunt popliteal artery injury. Eur J Trauma Emerg Surg 49, 1989–1996 (2023). https://doi.org/10.1007/s00068-023-02268-y

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  • DOI: https://doi.org/10.1007/s00068-023-02268-y

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