Current Surgery Reports

, 3:35 | Cite as

Management of Lower Extremity Vascular Injuries: State of the Art

  • Rishi Rattan
  • Keith M. Jones
  • Nicholas NamiasEmail author
Trauma Surgery (J. Diaz, Section Editor)
Part of the following topical collections:
  1. Trauma Surgery


Expeditious evidence-based management of lower extremity vascular injury is essential to reduce morbidity. Advances in management, largely due to military conflicts, continue to improve outcomes and limb salvage. Diagnosis via an accurate physical exam and adjuncts such as arterial pressure index or computed tomography angiography allow for rapid management. Expedited restoration of flow to major vessels, temporary intravascular shunting in the damage control setting or to restore perfusion before fixation of skeletal injuries, and early fasciotomy remain fundamentals of treatment. While endovascular management has increased significantly in highly selected populations, there are no prospective randomized controlled trials on its use in lower extremity vascular injury and it remains an experimental, off-label approach without any long-term outcomes data. Knowledge of various complications, including those requiring early return to the operating room, are critical to ensure satisfactory outcome.


Trauma Vascular injury Lower extremity vascular injury Limb salvage Fasciotomy Endovascular management 



Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. 1.
    Hughes CW. Arterial repair during the Korean war. Ann Surg. 1958;147(4):555–61.PubMedCentralPubMedGoogle Scholar
  2. 2.
    Rich NM, Baugh JH, Hughes CW. Acute arterial injuries in Vietnam: 1,000 cases. J Trauma. 1970;10(5):359–69.CrossRefPubMedGoogle Scholar
  3. 3.
    Fox CJ, Gillespie DL, O’Donnell SD, Rasmussen TE, Goff JM, Johnson CA, et al. Contemporary management of wartime vascular trauma. J Vasc Surg. 2005;41(4):638–44.CrossRefPubMedGoogle Scholar
  4. 4.
    • Feliciano DV, Moore EE, West MA, Moore FA, Davis JW, Cocanour CS, et al. Western Trauma Association critical decisions in trauma: evaluation and management of peripheral vascular injury, part II. J Trauma Acute Care Surg. 2013;75(3):391–7. Evidence-based US guideline on operative management of peripheral vascular injury. Google Scholar
  5. 5.
    •• Stahel PF, Smith WR, Hak DJ. Lower extremity. In: Mattox KL, Moore EE, Feliciano DV, editors. Trauma. 7th ed. New York: McGraw Hill; 2013. p. 783–815. Seminal textbook on trauma. Google Scholar
  6. 6.
    Barmparas G, Inaba K, Talving P, David JS, Lam L, Plurad D, et al. Pediatric vs adult vascular trauma: a National Trauma Databank review. J Pediatr Surg. 2010;45(7):1404–12.CrossRefPubMedGoogle Scholar
  7. 7.
    • DuBose JJ, Savage SA, Fabian TC, Menaker J, Scalea T, Holcomb JB, et al. The American Association for the Surgery of Trauma PROspective Observational Vascular Injury Treatment (PROOVIT) registry: multicenter data on modern vascular injury diagnosis, management, and outcomes. J Trauma Acute Care Surg. 2015;78(2):215–22; discussion 22–3. Observational study on current management of vascular injuries in the US. Google Scholar
  8. 8.
    Kauvar DS, Kraiss LW. Vascular trauma: extremity. In: Cronenwett JL, Johnston KW, editors. Rutherford’s vascular surgery. 8th ed. Philadelphia: Elsevier Saunders; 2014. p. 2485–500.Google Scholar
  9. 9.
    Kauvar DS, Sarfati MR, Kraiss LW. National trauma databank analysis of mortality and limb loss in isolated lower extremity vascular trauma. J Vasc Surg. 2011;53(6):1598–603.CrossRefPubMedGoogle Scholar
  10. 10.
    Perkins ZB, De’Ath HD, Aylwin C, Brohi K, Walsh M, Tai NR. Epidemiology and outcome of vascular trauma at a British Major Trauma Centre. Eur J Vasc Endovasc Surg. 2012;44(2):203–9.CrossRefPubMedGoogle Scholar
  11. 11.
    Franz RW, Shah KJ, Halaharvi D, Franz ET, Hartman JF, Wright ML. A 5-year review of management of lower extremity arterial injuries at an urban level I trauma center. J Vasc Surg. 2011;53(6):1604–10.CrossRefPubMedGoogle Scholar
  12. 12.
    Feliciano DV, Herskowitz K, O’Gorman RB, Cruse PA, Brandt ML, Burch JM, et al. Management of vascular injuries in the lower extremities. J Trauma. 1988;28(3):319–28.CrossRefPubMedGoogle Scholar
  13. 13.
    Rozycki GS, Tremblay LN, Feliciano DV, McClelland WB. Blunt vascular trauma in the extremity: diagnosis, management, and outcome. J Trauma. 2003;55(5):814–24.CrossRefPubMedGoogle Scholar
  14. 14.
    Mattox KL, Feliciano DV, Burch J, Beall AC Jr, Jordan GL Jr, De Bakey ME. Five thousand seven hundred sixty cardiovascular injuries in 4459 patients. Epidemiologic evolution 1958 to 1987. Ann Surg. 1989;209(6):698–705; discussion 6–7.Google Scholar
  15. 15.
    Sise MJ, Shackford SR. Peripheral vascular injury. In: Mattox KL, Moore EE, Feliciano DV, editors. Trauma. 7th ed. New York: McGraw Hill; 2013. p. 816–49.Google Scholar
  16. 16.
    Weaver FA, Yellin AE, Bauer M, Oberg J, Ghalambor N, Emmanuel RP, et al. Is arterial proximity a valid indication for arteriography in penetrating extremity trauma? A prospective analysis. Arch Surg. 1990;125(10):1256–60.CrossRefPubMedGoogle Scholar
  17. 17.
    Frykberg ER, Dennis JW, Bishop K, Laneve L, Alexander RH. The reliability of physical examination in the evaluation of penetrating extremity trauma for vascular injury: results at one year. J Trauma. 1991;31(4):502–11.CrossRefPubMedGoogle Scholar
  18. 18.
    Applebaum R, Yellin AE, Weaver FA, Oberg J, Pentecost M. Role of routine arteriography in blunt lower-extremity trauma. Am J Surg. 1990;160(2):221–4; discussion 4–5.Google Scholar
  19. 19.
    Lynch K, Johansen K. Can Doppler pressure measurement replace “exclusion” arteriography in the diagnosis of occult extremity arterial trauma? Ann Surg. 1991;214(6):737–41.PubMedCentralCrossRefPubMedGoogle Scholar
  20. 20.
    •• Kumar NG, Knipp BS, Gillespie DL. Lower extremity vascular trauma. In: Rasmussen TE, Tai NRM, editors. Rich’s Vascular Trauma. 3rd ed. Philadelphia: Elsevier; 2015. p. 168–82. Seminal textbook on vascular trauma. Google Scholar
  21. 21.
    • Fox N, Rajani RR, Bokhari F, Chiu WC, Kerwin A, Seamon MJ, et al. Evaluation and management of penetrating lower extremity arterial trauma: an Eastern Association for the Surgery of Trauma practice management guideline. J Trauma Acute Care Surg. 2012;73(5 Suppl 4):S315–20. Evidence-based US guideline on management of penetrating lower extremity arterial injury. Google Scholar
  22. 22.
    Patterson BO, Holt PJ, Cleanthis M, Tai N, Carrell T, Loosemore TM, et al. Imaging vascular trauma. Br J Surg. 2012;99(4):494–505.CrossRefPubMedGoogle Scholar
  23. 23.
    Seamon MJ, Smoger D, Torres DM, Pathak AS, Gaughan JP, Santora TA, et al. A prospective validation of a current practice: the detection of extremity vascular injury with CT angiography. J Trauma. 2009;67(2):238–43; discussion 43–4.Google Scholar
  24. 24.
    Melton SM, Croce MA, Patton JH Jr, Pritchard FE, Minard G, Kudsk KA, et al. Popliteal artery trauma. Systemic anticoagulation and intraoperative thrombolysis improves limb salvage. Ann Surg. 1997;225(5):518–27; discussion 27–9.Google Scholar
  25. 25.
    Itani KM, Burch JM, Spjut-Patrinely V, Richardson R, Martin RR, Mattox KL. Emergency center arteriography. J Trauma. 1992;32(3):302–6; discussion 6–7.Google Scholar
  26. 26.
    Inaba K, Potzman J, Munera F, McKenney M, Munoz R, Rivas L, et al. Multi-slice CT angiography for arterial evaluation in the injured lower extremity. J Trauma. 2006;60(3):502–6; discussion 6–7.Google Scholar
  27. 27.
    Bynoe RP, Miles WS, Bell RM, Greenwold DR, Sessions G, Haynes JL, et al. Noninvasive diagnosis of vascular trauma by duplex ultrasonography. J Vasc Surg. 1991;14(3):346–52.CrossRefPubMedGoogle Scholar
  28. 28.
    Bergstein JM, Blair JF, Edwards J, Towne JB, Wittmann DH, Aprahamian C, et al. Pitfalls in the use of color-flow duplex ultrasound for screening of suspected arterial injuries in penetrated extremities. J Trauma. 1992;33(3):395–402.CrossRefPubMedGoogle Scholar
  29. 29.
    Kragh JF, Beebe DF, Fox CJ, Beekley AC, Cain JS, et al. Survey of the indications for use of emergency tourniquets. J Spec Oper Med. 2011;11(1):30–8.PubMedGoogle Scholar
  30. 30.
    Kragh JF Jr, Walters TJ, Baer DG, Fox CJ, Wade CE, Salinas J, et al. Survival with emergency tourniquet use to stop bleeding in major limb trauma. Ann Surg. 2009;249(1):1–7.CrossRefPubMedGoogle Scholar
  31. 31.
    Glass GE, Pearse MF, Nanchahal J. Improving lower limb salvage following fractures with vascular injury: a systematic review and new management algorithm. J Plast Reconstr Aesthet Surg. 2009;62(5):571–9.CrossRefPubMedGoogle Scholar
  32. 32.
    Romanoff H, Goldberger S. Combined severe vascular and skeletal trauma. Management and results. J Cardiovasc Surg (Torino). 1979;20(5):493–8.Google Scholar
  33. 33.
    Bechara C, Huynh TT, Lin PH. Management of lower extremity arterial injuries. J Cardiovasc Surg (Torino). 2007;48(5):567–79.Google Scholar
  34. 34.
    Feliciano DV, Moore FA, Moore EE, West MA, Davis JW, Cocanour CS, et al. Evaluation and management of peripheral vascular injury. Part 1. Western Trauma Association/critical decisions in trauma. J Trauma. 2011;70(6):1551–6.CrossRefPubMedGoogle Scholar
  35. 35.
    Dennis JW, Frykberg ER, Veldenz HC, Huffman S, Menawat SS. Validation of nonoperative management of occult vascular injuries and accuracy of physical examination alone in penetrating extremity trauma: 5- to 10-year follow-up. J Trauma. 1998;44(2):243–52; discussion 2–3.Google Scholar
  36. 36.
    Stain SC, Yellin AE, Weaver FA, Pentecost MJ. Selective management of nonocclusive arterial injuries. Arch Surg. 1989;124(10):1136–40; discussion 40–1.Google Scholar
  37. 37.
    Frykberg ER, Crump JM, Dennis JW, Vines FS, Alexander RH. Nonoperative observation of clinically occult arterial injuries: a prospective evaluation. Surgery. 1991;109(1):85–96.PubMedGoogle Scholar
  38. 38.
    Taller J, Kamdar JP, Greene JA, Morgan RA, Blankenship CL, Dabrowski P, et al. Temporary vascular shunts as initial treatment of proximal extremity vascular injuries during combat operations: the new standard of care at Echelon II facilities? J Trauma. 2008;65(3):595–603.CrossRefPubMedGoogle Scholar
  39. 39.
    Ding W, Wu X, Li J. Temporary intravascular shunts used as a damage control surgery adjunct in complex vascular injury: collective review. Injury. 2008;39(9):970–7.CrossRefPubMedGoogle Scholar
  40. 40.
    Granchi T, Schmittling Z, Vasquez J, Schreiber M, Wall M. Prolonged use of intraluminal arterial shunts without systemic anticoagulation. Am J Surg. 2000;180(6):493–6; discussion 6–7.Google Scholar
  41. 41.
    Subramanian A, Vercruysse G, Dente C, Wyrzykowski A, King E, Feliciano DV. A decade’s experience with temporary intravascular shunts at a civilian level I trauma center. J Trauma. 2008;65(2):316–24; discussion 24–6.Google Scholar
  42. 42.
    Scott DJ, Rasmussen TE. Surgical damage control and temporary vascular shunts. In: Rasmussen TE, Tai NRM, editors. Rich’s vascular trauma. 3rd ed. Philadelphia: Elsevier; 2015. p. 198–205.Google Scholar
  43. 43.
    Rasmussen TE, Clouse WD, Jenkins DH, Peck MA, Eliason JL, Smith DL. The use of temporary vascular shunts as a damage control adjunct in the management of wartime vascular injury. J Trauma. 2006;61(1):8–12; discussion-5.Google Scholar
  44. 44.
    Chambers LW, Green DJ, Sample K, Gillingham BL, Rhee P, Brown C, et al. Tactical surgical intervention with temporary shunting of peripheral vascular trauma sustained during Operation Iraqi Freedom: one unit’s experience. J Trauma. 2006;61(4):824–30.CrossRefPubMedGoogle Scholar
  45. 45.
    Bleabea J, Choudry R. Civilian experience with temporary arterial shunts. In: Eskandari MK, Morasch MD, Pearce WH, Yao JST, editors. Vascular surgery: therapeutic strategies. Shelton: People’s Medical Publishing House; 2010. p. 193–202.Google Scholar
  46. 46.
    Houston R IV, Rasmussen TE. Utilization of shunting. In: Dua A, Desai SS, Holcomb JB, Burgess AR, Freischlag JA, editors. Clinical review of vascular trauma. New York: Springer; 2014. p. 355–66.CrossRefGoogle Scholar
  47. 47.
    Vertrees A, Fox CJ, Quan RW, Cox MW, Adams ED, Gillespie DL. The use of prosthetic grafts in complex military vascular trauma: a limb salvage strategy for patients with severely limited autologous conduit. J Trauma. 2009;66(4):980–3.CrossRefPubMedGoogle Scholar
  48. 48.
    Martin LC, McKenney MG, Sosa JL, Ginzburg E, Puente I, Sleeman D, et al. Management of lower extremity arterial trauma. J Trauma. 1994;37(4):591–8; discussion 8–9.Google Scholar
  49. 49.
    Shah DM, Leather RP, Corson JD, Karmody AM. Polytetrafluoroethylene grafts in the rapid reconstruction of acute contaminated peripheral vascular injuries. Am J Surg. 1984;148(2):229–33.CrossRefPubMedGoogle Scholar
  50. 50.
    Feliciano DV, Mattox KL, Graham JM, Bitondo CG. Five-year experience with PTFE grafts in vascular wounds. J Trauma. 1985;25(1):71–82.CrossRefPubMedGoogle Scholar
  51. 51.
    Trooskin SZ, Sclafani S, Winfield J, Duncan AO, Scalea T, Vieux E, et al. The management of vascular injuries of the extremity associated with civilian firearms. Surg Gynecol Obstet. 1993;176(4):350–4.PubMedGoogle Scholar
  52. 52.
    Degiannis E, Levy RD, Sofianos C, Florizoone MG, Saadia R. Arterial gunshot injuries of the extremities: a South African experience. J Trauma. 1995;39(3):570–5.CrossRefPubMedGoogle Scholar
  53. 53.
    • Watson JD, Houston RT, Morrison JJ, Gifford SM, Rasmussen TE. A retrospective cohort comparison of expanded polytetrafluorethylene to autologous vein for vascular reconstruction in modern combat casualty care. Ann Vasc Surg. 2015;29(4):822–9. Retrospective study demonstrating superiority of AVG in long-term outcomes. Google Scholar
  54. 54.
    Losel-Sadee H, Alefelder C. Heparin-bonded expanded polytetrafluoroethylene graft for infragenicular bypass: five-year results. J Cardiovasc Surg (Torino). 2009;50(3):339–43.Google Scholar
  55. 55.
    Feliciano DV, Accola KD, Burch JM, Spjut-Patrinely V. Extraanatomic bypass for peripheral arterial injuries. Am J Surg. 1989;158(6):506–9; discussion 9–10.Google Scholar
  56. 56.
    • Farber A, Tan TW, Hamburg NM, Kalish JA, Joglar F, Onigman T, et al. Early fasciotomy in patients with extremity vascular injury is associated with decreased risk of adverse limb outcomes: a review of the National Trauma Data Bank. Injury. 2012;43(9):1486–91. Retrospective database review supporting early fasciotomy to improve limb salvage and functional outcomes. Google Scholar
  57. 57.
    Branco BC, Inaba K, Barmparas G, Schnuriger B, Lustenberger T, Talving P, et al. Incidence and predictors for the need for fasciotomy after extremity trauma: a 10-year review in a mature level I trauma centre. Injury. 2011;42(10):1157–63.CrossRefPubMedGoogle Scholar
  58. 58.
    Reuben BC, Whitten MG, Sarfati M, Kraiss LW. Increasing use of endovascular therapy in acute arterial injuries: analysis of the National Trauma Data Bank. J Vasc Surg. 2007;46(6):1222–6.CrossRefPubMedGoogle Scholar
  59. 59.
    • Worni M, Scarborough JE, Gandhi M, Pietrobon R, Shortell CK. Use of endovascular therapy for peripheral arterial lesions: an analysis of the National Trauma Data Bank from 2007 to 2009. Ann Vasc Surg. 2013;27(3):299–305. Epidemiologic study on increasing use in the US of off-label endovascular therapy for peripheral arterial injury. Google Scholar
  60. 60.
    • Branco BC, DuBose JJ, Zhan LX, Hughes JD, Goshima KR, Rhee P, et al. Trends and outcomes of endovascular therapy in the management of civilian vascular injuries. J Vasc Surg. 2014;60(5):1297–307, 307 e1. A review of the outcomes of endovascular management of vascular trauma. Google Scholar
  61. 61.
    Sise MJ, Shackford SR. Extremity vascular trauma. In: Rich NM, Mattox KL, Wakefield TW, editors. vascular trauma. 2nd ed. Philadelphia: Elsevier Saunders; 2004. p. 353–89.CrossRefGoogle Scholar
  62. 62.
    Gargiulo NJ, Ohki T, Cayne NS, Veith FJ. Endovascular grafts for traumatic vascular lesions. In: Rich NM, Mattox KL, Hirshberg A, editors. Vascular trauma. 2nd ed. Philadelphia: Elsevier Saunders; 2004. p. 207–20.CrossRefGoogle Scholar
  63. 63.
    Doody O, Given MF, Lyon SM. Extremities—indications and techniques for treatment of extremity vascular injuries. Injury. 2008;39(11):1295–303.CrossRefPubMedGoogle Scholar
  64. 64.
    White R, Krajcer Z, Johnson M, Williams D, Bacharach M, O’Malley E. Results of a multicenter trial for the treatment of traumatic vascular injury with a covered stent. J Trauma. 2006;60(6):1189–95; discussion 95–6.Google Scholar
  65. 65.
    Asensio JA, Kuncir EJ, Garcia-Nunez LM, Petrone P. Femoral vessel injuries: analysis of factors predictive of outcomes. J Am Coll Surg. 2006;203(4):512–20.CrossRefPubMedGoogle Scholar
  66. 66.
    Mullenix PS, Steele SR, Andersen CA, Starnes BW, Salim A, Martin MJ. Limb salvage and outcomes among patients with traumatic popliteal vascular injury: an analysis of the National Trauma Data Bank. J Vasc Surg. 2006;44(1):94–100.CrossRefPubMedGoogle Scholar
  67. 67.
    Hafez HM, Woolgar J, Robbs JV. Lower extremity arterial injury: results of 550 cases and review of risk factors associated with limb loss. J Vasc Surg. 2001;33(6):1212–9.CrossRefPubMedGoogle Scholar
  68. 68.
    Wagner WH, Calkins ER, Weaver FA, Goodwin JA, Myles RA, Yellin AE. Blunt popliteal artery trauma: one hundred consecutive injuries. J Vasc Surg. 1988;7(5):736–43.CrossRefPubMedGoogle Scholar
  69. 69.
    Barnes CJ, Pietrobon R, Higgins LD. Does the pulse examination in patients with traumatic knee dislocation predict a surgical arterial injury? A meta-analysis. J Trauma. 2002;53(6):1109–14.CrossRefPubMedGoogle Scholar
  70. 70.
    Rowe VL, Pourrabbani S, Weaver FA. Blunt popliteal artery injuries. In: Stanley JC, Veith FJ, Wakefield TW, editors. Current therapy in vascular and endovascular surgery. 5th ed. Philadelphia: Elsevier Saunders; 2014. p. 686–9.Google Scholar
  71. 71.
    Scalea JR, Crawford R, Scurci S, Danquah J, Sarkar R, Kufera J, et al. Below-the-knee arterial injury: the type of vessel may be more important than the number of vessels injured. J Trauma Acute Care Surg. 2014;77(6):920–5.CrossRefPubMedGoogle Scholar
  72. 72.
    Padberg FT Jr, Rubelowsky JJ, Hernandez-Maldonado JJ, Milazzo V, Swan KG, Lee BC, et al. Infrapopliteal arterial injury: prompt revascularization affords optimal limb salvage. J Vasc Surg. 1992;16(6):877–85; discussion 85–6.Google Scholar
  73. 73.
    Whitman GR, McCroskey BL, Moore EE, Pearce WH, Moore FA. Traumatic popliteal and trifurcation vascular injuries: determinants of functional limb salvage. Am J Surg. 1987;154(6):681–4.CrossRefPubMedGoogle Scholar
  74. 74.
    Keeley SB, Snyder WH 3rd, Weigelt JA. Arterial injuries below the knee: fifty-one patients with 82 injuries. J Trauma. 1983;23(4):285–92.CrossRefPubMedGoogle Scholar
  75. 75.
    Burkhardt GE, Cox M, Clouse WD, Porras C, Gifford SM, Williams K, et al. Outcomes of selective tibial artery repair following combat-related extremity injury. J Vasc Surg. 2010;52(1):91–6.CrossRefPubMedGoogle Scholar
  76. 76.
    Timberlake GA, Kerstein MD. Venous injury: to repair or ligate, the dilemma revisited. Am Surg. 1995;61(2):139–45.PubMedGoogle Scholar
  77. 77.
    Khaneja SC, Arrillaga A, Ernst A, Picard DL, Pizzi WF. Outcome in the Management of Penetrating Venous Injury. Vasc Surg. 1994;28(1):39–44.CrossRefGoogle Scholar
  78. 78.
    Yelon JA, Scalea TM. Venous injuries of the lower extremities and pelvis: repair versus ligation. J Trauma. 1992;33(4):532–6; discussion 6–8.Google Scholar
  79. 79.
    Arrillaga A, Bynoe RP, Frykberg ER, Nagy K. Penetrating venous extremity trauma, management of: Eastern Association for the Surgery of Trauma; 2002. Accessed 4 Aug 2015.
  80. 80.
    Smith LM, Block EF, Buechter KJ, Draughn DC, Watson D, Hedden W. The natural history of extremity venous repair performed for trauma. Am Surg. 1999;65(2):116–20.PubMedGoogle Scholar
  81. 81.
    Kuralay E, Demirkilic U, Ozal E, Oz BS, Cingoz F, Gunay C, et al. A quantitative approach to lower extremity vein repair. J Vasc Surg. 2002;36(6):1213–8.CrossRefPubMedGoogle Scholar
  82. 82.
    • Allen CJ, Hsu A, Murray CR, Meizoso JP, Ray JJ, Schulman CI, et al. Risk of pulmonary embolism with repair or ligation of major venous injury following penetrating trauma. J Trauma Acute Care Surg. 2015;78(3):580–5. Study demonstrating similar pulmonary embolism rate whether or not venous injuries are repaired or ligated. Google Scholar
  83. 83.
    Quan RW, Gillespie DL, Stuart RP, Chang AS, Whittaker DR, Fox CJ. The effect of vein repair on the risk of venous thromboembolic events: a review of more than 100 traumatic military venous injuries. J Vasc Surg. 2008;47(3):571–7.CrossRefPubMedGoogle Scholar
  84. 84.
    Parry NG, Feliciano DV, Burke RM, Cava RA, Nicholas JM, Dente CJ, et al. Management and short-term patency of lower extremity venous injuries with various repairs. Am J Surg. 2003;186(6):631–5.CrossRefPubMedGoogle Scholar
  85. 85.
    Rasmussen TE, Stannard A. Injury to extremities. In: Fischer J, editor. Mastery of surgery. 6th ed. Philadelphia: Lippincott Williams & Wilkins; 2012. p. 2495–504.Google Scholar
  86. 86.
    Fox CJ. Open and endovascular treatment of penetrating extremity arterial injuries. In: Stanley JC, Veith FJ, Wakefield TW, editors. Current therapy in vascular and endovascular surgery. 5th ed. Philadelphia: Elsevier Saunders; 2014. p. 682–6.Google Scholar
  87. 87.
    •• Qu Z, Chaikof EL. Prosthetic grafts. In: Cronenwett JL, Johnston KW, editors. Rutherford’s vascular surgery. 8th ed. Philadelphia: Elsevier Saunders; 2014. p. 1402–18. Seminal textbook on vascular surgery, both traumatic and non-traumatic. Google Scholar
  88. 88.
    Fuchs S, Heyse T, Rudofsky G, Gosheger G, Chylarecki C. Continuous passive motion in the prevention of deep-vein thrombosis: a randomised comparison in trauma patients. J Bone Joint Surg Br. 2005;87(8):1117–22.CrossRefPubMedGoogle Scholar
  89. 89.
    Rich NM. Historic review of arteriovenous fistulas and traumatic false aneurysms. In: Rich NM, Mattox KL, Hirshberg A, editors. Vascular trauma. 2nd ed. Philadelphia: Elsevier Saunders; 2004. p. 457–524.CrossRefGoogle Scholar
  90. 90.
    Berceli SA. Autogenous grafts. In: Cronenwett JL, Johnston KW, editors. Rutherford’s vascular surgery. 8th ed. Philadelphia: Elsevier Saunders; 2014. p. 1382–401.Google Scholar

Copyright information

© Springer Science + Business Media New York 2015

Authors and Affiliations

  • Rishi Rattan
    • 1
    • 2
  • Keith M. Jones
    • 2
    • 3
  • Nicholas Namias
    • 1
    • 2
    Email author
  1. 1.Division of Trauma and Acute Care Surgery, Daughtry Family Department of SurgeryUniversity of Miami Miller School of MedicineMiamiUSA
  2. 2.Ryder Trauma CenterJackson Memorial HospitalMiamiUSA
  3. 3.Division of Vascular Surgery, Daughtry Family Department of SurgeryUniversity of Miami Miller School of MedicineMiamiUSA

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