• Anahita Dua, Sapan S Desai, Sean Johnston, Naga R Chinapuvvula, Joseph DuBose, Kristofer Charlton-Ouw, Ali Azizzadeh, Andrew Burgess, Charles E Wade, Charles J Fox, and John B Holcomb.
• Center for Translational Injury Research (CeTIR), Department of Surgery, University of Texas-Houston, TX, USA Department of Surgery, Medical College of Wisconsin, WI, USA andua@mcw.edu.
• Vascular. 2015 Oct 1;23(5):468-73.

IntroductionTrauma patients with sudden loss of distal perfusion due to tibial injuries are frequently not offered vascular interventions if a single vessel retains patency. We hypothesized that sudden loss of either all or some tibial vasculature would result in increased non-operative failure and higher amputation rates.MethodsIn this retrospective observational study, all traumatically injured patients from 2009 to 2012 with CT-angiogram-confirmed anterior tibial, posterior tibial, or peroneal artery injuries were included.ResultsFrom 2009 to 2012, 437 patients were admitted with arterial extremity injury of which 234 (53%) were lower extremity. From this group, 84 (36%) patients were identified with CT-angiogram-confirmed limited or no flow in the tibial arteries. A total of 44% (4/9) with 0 or 1 tibial vessel failed observation while only 8% (2/27) failed if they had 2 or 3 patent vessels (p < 0.05). Amputation rate was inversely related the number of open tibial vessels. There were 2.7 open tibial vessels in the limb salvage group compared to 1.1 in the amputation group (p < 0.05).ConclusionPatients who failed an initial trial of observation were significantly more likely to have 0 or 1 tibial vessels patent. The number of open tibial vessels is significantly associated with limb salvage.© The Author(s) 2014.

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