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Risk Factors of Amputation in Lower Extremity Trauma with Combined Femoropopliteal Arterial Injury
Vasc Spec Int 2019;35:16-21
Published online March 31, 2019;
© 2019 The Korean Society for Vascular Surgery.

JeaHwan Kim1, Yong Sun Jeon2, Soon Gu Cho2, Kee Chun Hong1, Keun-Myoung Park1

1Department of Surgery, Inha University Hospital, Incheon, Korea, 2Department of Radiology, Inha University Hospital, Incheon, Korea
Correspondence to: Keun-Myoung Park, Department of Surgery, Inha University Hospital, 27 Inhang-ro, Jung-gu, Incheon 22332, Korea, Tel: 82-32-890-2738, Fax: 82-32-890-3549, E-mail:,
Received August 10, 2018; Revised September 26, 2018; Accepted October 14, 2018.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.


The clinical characteristics and results of femoropopliteal artery injury (FPAI) remain unclear. In this study, we evaluated the outcomes and risk factors of limb loss in patients treated for FPAI.

Materials and Methods

We retrospectively reviewed data from a database of patients who underwent revascularization for an FPAI at a single institution between January 2013 and December 2017. We reviewed and analyzed the characteristics, postoperative results, and factors that influence amputation rates.


Twenty-four femoropopliteal arterial reconstructions in 24 patients were included in this study. Among the patients were 20 (83.3%) male with a first-quartile age of 28 years and a third-quartile age of 45 years (range, 15–68 years). The mean injury severity score (ISS) was 16 (range, 4–55), and 5 patients (20.8%) had ISSs of >20 points. The mean mangled extremity severity score (MESS) was 3.8 (range, 1–11), and 8 patients (33.3%) had MESSs of >5 points. In terms of arterial reconstruction methods, autogenous saphenous vein grafting, vein patching, and primary closure were performed in 9 patients (37.5%), 4 patients (16.7%), and 11 patients (45.8%), respectively. Despite arterial reconstruction, 5 patients (20.8%) underwent above-knee amputation. ISSs of >20, MESSs of >7, and orthopedic fixation were statistically significant factors associated with amputation.


In cases of FPAI with ISSs of >20, MESSs of >7, and orthopedic fixation, amputations should be considered. We were also careful to attempt limb salvage in such cases.

Keywords: Vascular injury, Femoral artery, Popliteal artery, Traumatic amputation

March 2020, 36 (1)
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