Amputation Risk Factors in Concomitant Superficial Femoral Artery and Vein Injuries

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Abstract
Only a small subset of patients with combined superficial femoral artery and vein injuries results in amputation. The importance of the venous component as a risk factor for amputation is uncertain. Ligation vs. reconstruction of venous injuries is controversial. For clarification of these issues, multiple risk factors for amputation in combined superficial femoral artery and vein injuries in a civilian population were analyzed retrospectively. There were 25 patients treated in a 20-yr period. Some 16 injuries were caused by small caliber missiles, 6 by shotgun blasts and 3 by knife wounds. Three patients (12%) ultimately underwent amputation. The major risk factor for amputation was the method of vascular reconstruction. All 3 amputations underwent ligation of the superficial femoral vein with arterial reconstruction by placement of a reversed interposition saphenous vein graft (P = 0.0009). None of the remaining 22 patients with salvaged limbs underwent reconstruction by this combination of techniques. The importance of venous reconstruction, particularly in combined injuries with major arterial involvement requiring interposed grafts was emphasized.