Complete femoral artery transection following handlebar trauma

Abstract

Complete transection of the common femoral artery is more frequent after penetrating injuries than after blunt trauma, with most of the cases occurring in combination with fractures. Contusion from a bicycle handlebar is a rare form of injury to the femoral vessels. Hereby, we present a case of complete common femoral artery transection caused by a direct bicycle handlebar trauma. The patient suffered severe hypovolemia during his transfer to the Emergency room. He required an emergency intervention and a bypass reconstruction.

Traumatic right common femoral artery occlusion caused by blunt bicycle handlebar injury: a case report

“…To the best of our knowledge, in the past 20 years (1999–2018), there have been 38 similar reports of injuries of the EIA, CFA, or common iliac artery caused by blunt trauma [2–28]. The injuries were caused by handlebar trauma from bicycles [2, 3, 5–7, 11, 15, 20, 21, 24, 26], motorcycles [8, 18, 25], or all-terrain vehicles [13]; by other traffic accidents [5, 9, 10, 27]; by falling from a height [5, 22]; by being hit by a tennis ball [14]; and by blowing or compression of hard objects [5, 12, 19, 23, 28]. A rare case of CFA and vein avulsion from a hip hyperextension and abduction was also reported [17].…”

“…Although the patient in the present case was almost an adult, endovascular treatment was not indicated because the main injury site was CFA, which was an inappropriate zone for stenting. Thromboendarterectomy with graft interposition or patch repair and bypass grafting are standard procedures and may involve either synthetic or autologous grafts [1–18, 20–24, 26–28]. Autologous grafts are frequently preferred because the long-term patency of synthetic grafts in children is not known.…”

Death due to severe blood loss following an accidental lesion to the femoral vessels

“…Accidental femoral transections are usually reported as case reports or small case series. 9–11 The femoral artery is a continuation of the iliac artery; it is a large artery in the thigh and the main arterial supply to the thigh and leg. It passes superficially through the femoral triangle, and its pathway continues in the groin, where it divides into superficial and profound femoral arteries.…”

Superficial femoral artery transection following penetrating trauma

“…Arterial injuries can be categorized as partial transections, complete transections, contusions with thrombosis, intimal disruption and arterio-venous fistula. Complete transections can lead to vasospasms on each end with minimal bleeding minimizing the suspicion for major vascular injury [ 2 ]. There is an increased potential for missed vascular injuries in the absence of hard signs of vascular trauma after penetrating mechanism.…”