Methods: Between September 2009 and June 2013, a total of 161 patients (156 males, 5 females; mean age 30.3±11.8 years; range 8 to 80 years) were surgically treated for vascular injuries in our clinic. All patients were taken to the operation emergently after clinical assessment or after diagnostic imaging using Doppler ultrasound, computed tomography angiography or magnetic resonance angiography.

Results: Penetrating injuries (89.4%) were more common and most injuries involved the upper extremity (49.1%), followed by the lower extremity (41%), abdomen (5.6%), neck (2.5%), and thorax (1.9%). Simple ligation technique (14.3%) was used for small vessel injuries, whereas end-to-end anastomosis (49.7%) and repair with a saphenous vein (32.3%) or prosthetic graft (4.3%) was used for more complex cases. Mortality was seen in 10 patients (6.2%). Major risk factors for mortality were abdominal localization of injury (p<0.001), hemodynamic instability on admission (p<0.001) and low hematocrit levels before the operation (33.4±5.6 vs 18.1±9.1; p<0.001).

Conclusion: Vascular injuries should be diagnosed and treated promptly. The clinical status at the time of presentation, localization of injury, diversity of diagnostic and treatment options and concomitant injuries are important considerations. Only clinical assessment may be enough in many emergency cases. Patients with hemodynamic instability and major blood loss before the surgery should be managed with surgery and medical resuscitation simultaneously to prevent patient loss.