Use of stent grafts in lower extremity trauma.

BACKGROUND: Permanent endovascular stenting is gradually becoming recognized as a safe and efficacious method for treating a variety of arterial diseases. The literature on its application in trauma care is sparse, although indications for usage continue to evolve.

METHODS: We retrospectively reviewed all penetrating extremity trauma treated with endovascular therapy at our medical center between 2005 and 2008.

RESULTS: We present three patients with three different arterial lesions in the superficial femoral artery (SFA) which were caused by penetrating injury. The arterial lesions include a mid-thigh SFA pseudoaneurysm, an intimal disruption of the distal SFA, and an arteriovenous fistula involving the SFA and superficial femoral vein. All were treated with expanded polytetrafluoroethylene-covered stents and showed excellent short-term results. A percutaneous approach to this problem may reduce blood loss, decrease length of stay, involve fewer iatrogenic nerve injuries, and facilitate shorter recovery time, as compared with open approaches.

CONCLUSIONS: Endovascular-covered stent placement for traumatic arterial extremity injury was used with excellent results and no morbidity in this small series of patients. Endovascular solutions for arterial extremity injuries warrant further investigation for short- and long-term results.