Superficial femoral artery transection following penetrating trauma

Abstract

We describe a patient who sustained a penetrating injury to the posterior right lower extremity just above the popliteal region with transection of the superficial femoral artery (SFA) despite minimal evidence of active bleeding. An on-table angiogram identified flow in the SFA followed by the popliteal artery and into the trifurcation of the right lower extremity. Eventually, a second operation revealed transection followed by end-to-end anastomosis of SFA and stabilization of the patient. The findings of this case highlight the need for a high index of suspicion and persistent clinical investigation to identify vascular injuries in the absence of hard signs of vascular trauma.

Pseudoaneurysm of the proximal superficial femoral artery following blunt trauma in a footballer: A rare case report

“…Close proximity of the superficial femoral artery after passing through Hunter's canal and its superficial location makes it vulnerable for injury following blunt trauma. 5 Blaise and Pape also reported a similar case, but it was an isolated pseudoaneurysm of the deep femoral artery. 2 The pseudoaneurysm was excised in their case as we did in our case, but in the superficial femoral artery.…”

“…Close proximity of the superficial femoral artery after passing through Hunter's canal and its superficial location makes it vulnerable for injury following blunt trauma 5 …”

Combined injury of femoral artery and femoral nerve after blunt trauma to the proximal femur: A case report

“…Clinical signs of femoral artery injury are diminished pulse, limb ischemia, enlarging hematoma, and bleeding from the artery. Where these “hard” signs are present, clinical management includes an angiogram and surgical intervention [ 1 ]. Soft signs of femoral artery injury include nonexpanding hematoma, major wounds, and uncontrolled hypotension.…”

“…Soft signs of femoral artery injury include nonexpanding hematoma, major wounds, and uncontrolled hypotension. In these cases, femoral artery injury is more difficult to recognize, and additional diagnostic tools may be needed, including ankle-brachial index testing, computed tomography angiography, or conventional angiography [ 1 ].…”

“…Femoral neurovascular bundle transection is a devastating injury not commonly associated with blunt trauma to the proximal femur: it is more commonly associated with penetrating injuries to the femur such as gunshot wounds [ 1 ]. However, even blunt trauma around the hip may cause femoral artery transection, which may in turn result in morbidity, death, hemodynamic instability, limb loss, and permanent physical disability [ 1 ]. Blunt trauma to the femur may also damage the femoral nerve, thereby impairing knee extension and other basic motor functions [ 2 ].…”