ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
The importance of clinical observation for the diagnosis of deep femoral artery injuries and the place of ligation as an alternative treatment option
Mustafa Göz, Ömer Çakır, M. Nesimi Eren
Dicle Üniversitesi Tıp Fakültesi Kalp ve Damar Cerrahisi Anabilim Dalı, Diyarbakır
Background: We evaluated the value of clinical observation in addition to physical examination findings for the diagnosis of deep femoral artery (DFA) injuries and the option of ligation in cases where surgical repair was not possible.

Methods: Eleven male patients (mean age 27.5±11.4 years; range 17 to 49 years) who underwent ligation for DFA injuries were retrospectively evaluated with respect to demographic features, etiology, time from injury to presentation, physical examination findings at the emergency unit, diagnostic methods used, surgical procedures, and early and midterm results of treatment.

Results: Etiology was gun shot injury in six patients (54.6%) and stab wound in five patients (45.5%). Nine patients (81.8%) presented within the first two hours after trauma. The ankle-brachial pressure index (ABI) was 1 in all the patients. A large vascular defect was present in all the patients, involving the branches of the DFA. Five patients had an isolated DFA injury, while six patients had accompanying venous injuries. Four patients (36.4%) with active bleeding were promptly submitted to surgery because physical examination findings were sufficient for diagnosis. Seven patients (63.6%) were operated on after clinical observation ranging from 2 to 17 hours (mean 6.7 hours). The mean hospital stay was 9.3±7.1 days (range 4 to 24 days). Early postoperative complications included local wound infection in two patients. No pathological findings were detected during a mean follow-up period of 16.3±11.0 months (range 2 to 33 months).

Conclusion: Clinical observation up to 24 hours is important in patients whose manifestations of DFA injuries are not apparent. Measurement of ABI may not be a reliable tool for the diagnosis of DFA injuries. Ligation may be a treatment option in young cases in which surgical repair is not possible.

Keywords : Femoral artery/injuries; ligation; wounds, penetrating/ surgery
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