The Surgical Treatment of Arterial Injuries in the Civilian Population

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Abstract
Over 8 yr, 191 consecutive patients were treated for arterial injuries. Blunt trauma occurred in 46 patients (24%), low velocity gunshot wounds in 82 patients (43%), shotgun wounds in 22 patients (12%), stab wounds in 20 patients (10%), iatrogenic injury in 9 patients (5%), high velocity gunshot wounds in 2 patients (1%) and other penetrating wounds in 10 patients (5%). Preoperative arteriography was performed in 48 patients (25%) who were hemodynamically stable with injuries to major vessels in the thorax, base of neck or extremities and in whom the exact location or extent of injury was unknown. Surgical repair was performed in 184 of 191 patients (96%); 7 patients expired intraoperatively before reconstruction could take place. Repair was accomplished in the 184 patients by end-to-end primary anastomosis in 80 patients (44%), lateral sutures in 21 patients (11%), SVG (saphenous vein graft) in 71 patients (85%) and Dacron prosthesis in 13 patients (15%). Of the patients, 170 survived (89%) and 21 died (11%); 7 of the 21 deaths were intraoperative and 10 others were due to the effects of trauma to the aorta or its branches.