Limb salvage after delayed diagnosis for blunt traumatic infrapopliteal occlusion

J Vasc Surg. 2010 Sep;52(3):734-7. doi: 10.1016/j.jvs.2010.03.065. Epub 2010 Jun 8.

Abstract

Infrapopliteal occlusion is uncommon after blunt trauma, and limb salvage after delayed diagnosis is even rarer. We present the case of a 56-year-old man who had complex lower leg orthopedic fractures along with a reportedly normal pulse examination with an 11-day diagnostic delay of limb-threatening ischemia requiring distal revascularization. This case illustrates an incidence of delayed infrapopliteal three-vessel occlusion with successful revascularization and subsequent endovascular management to maintain patency. We describe the workup and treatment of delayed infrapopliteal occlusion and a review of the current literature on this topic.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Accidents, Traffic
  • Angioplasty
  • Arterial Occlusive Diseases / diagnosis
  • Arterial Occlusive Diseases / etiology
  • Arterial Occlusive Diseases / physiopathology
  • Arterial Occlusive Diseases / surgery*
  • Constriction, Pathologic
  • Delayed Diagnosis*
  • Fibula / injuries
  • Fibula / surgery
  • Fracture Fixation
  • Humans
  • Ischemia / diagnosis
  • Ischemia / etiology
  • Ischemia / physiopathology
  • Ischemia / surgery*
  • Limb Salvage*
  • Male
  • Middle Aged
  • Radiography
  • Saphenous Vein / transplantation*
  • Tibial Arteries / diagnostic imaging
  • Tibial Arteries / physiopathology
  • Tibial Arteries / surgery*
  • Tibial Fractures / etiology
  • Tibial Fractures / surgery
  • Time Factors
  • Treatment Outcome
  • Vascular Patency
  • Wounds, Nonpenetrating / diagnosis
  • Wounds, Nonpenetrating / etiology
  • Wounds, Nonpenetrating / surgery*