TITLE:
Etiology and Surgical Management of Penetrating Arterial Trauma of Limbs in Toamasina
AUTHORS:
Medyno Lovasoa Mampiadana, Fanomezantsoa Raherinantenaina, Zakarimanana Lucas Randimbinirina, Andriamihaja Jean-Claude Rakotoarisoa, Toky Mamin’ny Aina Rajaonanahary
KEYWORDS:
Artery, Vascular Injury, Limbs, Surgery, Trauma
JOURNAL NAME:
World Journal of Cardiovascular Surgery,
Vol.14 No.11,
November
29,
2024
ABSTRACT: Background: The prevalence of penetrating arterial trauma of limbs remains unknown in Toamasina. Their management remains a challenge due to lack of protocol and late in admission of victims. The aim of this study was to describe etiology and surgical management of penetrating traumatic arterial injuries of limbs in Toamasina. Material and Methods: This was a retrospective and descriptive study for 6 years period (from 1st January 2017 to 31th December 2022) performed at Vascular Surgery Unit of Morafeno Teaching Hospital in Toamasina, Madagascar, including all patients who underwent surgery due to penetrating traumatic arterial injuries of limbs. Demographics, circumstance of accident, symptomatology, characteristics of arterial injury, surgical procedures and outcomes were analyzed. Results: Thirty-five cases of penetrating arterial trauma of limbs were recorded. The most victims were young (mean age = 31.27) male (96.43%). Arterial injuries were due to stab wounds in 85.17% of cases. The most common symptoms were bleeding (89.12%) and pulseless (46.73%). Most patients (82.85%) used tourniquets to control the bleeding before admission. Lesions were laceration (34.28%), transection (48.57%) and avulsion (17.14%). Arterial injuries were located in upper extremities in 20 cases (71.42%). The most involved vessels were the brachial artery (45.71%) and radial artery (34.28%). Surgical procedures were end-to-end anastomosis (45.71%), lateral arteriorraphy (25.71%), interposition of reverse saphenous vein graft (17.14%) and ligation (8.57%). Primary amputation was performed for 1 patient after delayed acute ischemia (2.85%). There was no death among patients who underwent surgery. The overall limb salvage rate was 97.14%. Conclusion: Stabs were the most common etiology of penetrating arterial injuries in Toamasina. Surgical results were satisfactory despite the late in admission of majority of victims.