Iliac artery ischemic

Analysis of risks for ischemic complications

George Woodman, Martin Croce, Timothy C. Fabian

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Risk factors for lower extremity ischemic complications (ICs) following iliac arterial injuries have not been addressed. Patients with penetrating iliac artery injuries over a 15-year period were reviewed. IC was defined as compartment syndrome with or without tissue loss. Patients with iliac artery repair who developed ICs were compared with those without ICs (excluding early deaths from hemorrhagic shock). Comparison included demographics, severity of shock, physical examination, and operative findings. There were 94 arterial injuries in 80 patients (34 common iliac, 23 internal iliac, and 37 external iliac). There were 26 deaths (33%), and 3 patients were excluded for technical reasons. Of the 51 who underwent arterial reconstruction, 34 had no ischemia, whereas 17 (33%) had ICs (9 with tissue loss and 8 with compartment syndrome only). Immediate fasciotomies were performed in 6 of the IC patients due to the early recognition of compartment syndrome; 1 required amputation from the profound ischemia. Delayed recognition of compartment syndrome in the remaining 11 IC patients resulted in eight amputations (P < 0.05). We conclude that ICs following iliac arterial injuries significantly correlate with shock as indicated by systemic pH, lactate and transfusion requirements, and a preoperative pulseless extremity. In these patients, close monitoring of compartment pressures is necessary, and immediate fasciotomies should be strongly considered.

Original languageEnglish (US)
Pages (from-to)833-837
Number of pages5
JournalAmerican Surgeon
Volume64
Issue number9
StatePublished - Sep 1998

Fingerprint

Iliac Artery
Compartment Syndromes
Wounds and Injuries
Amputation
Shock
Ischemia
Hemorrhagic Shock
Physiologic Monitoring
Physical Examination
Lower Extremity
Lactic Acid
Extremities
Demography
Pressure

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

Iliac artery ischemic : Analysis of risks for ischemic complications. / Woodman, George; Croce, Martin; Fabian, Timothy C.

In: American Surgeon, Vol. 64, No. 9, 09.1998, p. 833-837.

Research output: Contribution to journalArticle

Woodman, G, Croce, M & Fabian, TC 1998, 'Iliac artery ischemic: Analysis of risks for ischemic complications', American Surgeon, vol. 64, no. 9, pp. 833-837.
Woodman, George ; Croce, Martin ; Fabian, Timothy C. / Iliac artery ischemic : Analysis of risks for ischemic complications. In: American Surgeon. 1998 ; Vol. 64, No. 9. pp. 833-837.
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