SURGICAL MANAGEMENT OF TRAUMATIC ARTERIAL OF LIMBS IN ANTANANARIVO

Abstract

Background: The prevalence of traumatic arterial of limbs in Antananarivo is unknown, and there is not a protocol for management of vascular trauma. The aim of this study was to describe epidemiology and surgical management of traumatic arterial of limbs in Antananarivo. 
 Material and methods: This was a retrospective and descriptive study for a period of 10 years from January 2008 to December 2017 performed at the Cardiovascular Surgery Unit in JRA Teaching Hospital Antananarivo, including all patients who underwent a surgery for traumatic arterial injury of limbs. 
 Results: Ninety-two cases of traumatic arterial of limbs has been recorded. The most victims were young (mean age=34.68), male (88.04%). The most mechanism of arterial injury was a civilian liability accident (63.04%) which 53.26% was due to stabs wounds. There were 82 cases of arterial wounds and 10 cases of blunt arterial trauma. Clinical signs were bleeding (89.12%), pulseless (46.73%) and hematoma (10.86%). Lesion were laceration (n=36), complete transection (n=32), avulsion (n=7), pseudoaneurysm (n=5), arteriovenous fistula (n=2), contusion (n=10). The most involved vessel were the brachial artery (29.34%) in the upper extremity and the femoral artery (15.21%) in lower extremity. Surgical procedure were revascularization (84.78%), ligation (9.78%) and primary amputation (5.43%). The overall limb salvage rate was 96.73% of arterial injuries successfully repaired. 
 Conclusion: Revascularization is important in traumatic arterial injury of limbs. It must giving early to prevent an amputation of limbs.