Successful Prosthetics for Traumatic Femoral Vascular Injury: А Case Report

Abstract

Background. Injury to the main vessels is often accompanied by life-threatening bleeding, permanent disability or death. In the modern literature, only isolated cases of reconstructive surgery for major vein injury are described, their long-term results are insufficiently studied, there is little information about the introduction of telemedicine technologies into the practice of emergency angiosurgical care. The aim of the study is to demonstrate the immediate and long-term results of the joint work of trauma surgeons and angiosurgeons in helping a patient with injury to the main femoral vessels. Case presentation. The results of treatment of the patient with the diagnosis: laceration of the upper third of the right thigh with rupture of the common femoral vein and superficial femoral artery and the development of threatening ischemia of the right lower limb; severe blood loss; hemorrhagic shock IV; severity of injury: VPH SP 33; MESS 7. Treatment of the patient took place in several stages. At the first of them, hemostasis was performed, the hemorrhagic shock was resolved. Further, the patient was consulted by an angiosurgeon through telecommunication technologies, after which it was decided to include an angiosurgeon in the surgical team. The prosthetics of femoral vessels was performed: the main venous and arterial blood flow was restored in the affected limb. The patient was discharged in a satisfactory condition with no signs of thrombosis. Conclusions. Compliance with consistent actions in helping a patient with a vascular injury prevents the development of a deadly triad and a fatal outcome. The use of telemedicine consultations provides the angiosurgeon with the opportunity to remotely assess the clinical picture, the severity of the injury, discuss the sequence and volume of necessary medical care at the place of primary hospitalization. Performing reconstructive surgeries using various types of grafts allows you to restore the main blood flow through damaged vessels with good immediate and long-term results.