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Management of Lower Extremity Vascular Injuries: State of the Art

  • Trauma Surgery (J. Diaz, Section Editor)
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Abstract

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.

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  1. Division of Trauma and Acute Care Surgery, Daughtry Family Department of Surgery, University of Miami Miller School of Medicine, PO Box 016960 (D-40), Miami, FL, 33101, USA

    Rishi Rattan & Nicholas Namias

  2. Ryder Trauma Center, Jackson Memorial Hospital, Miami, FL, USA

    Rishi Rattan, Keith M. Jones & Nicholas Namias

  3. Division of Vascular Surgery, Daughtry Family Department of Surgery, University of Miami Miller School of Medicine, Miami, FL, USA

    Keith M. Jones

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  1. Rishi Rattan
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Rattan, R., Jones, K.M. & Namias, N. Management of Lower Extremity Vascular Injuries: State of the Art. Curr Surg Rep 3, 35 (2015). https://doi.org/10.1007/s40137-015-0118-x

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