Although vascular surgery guidelines recommend immediate anticoagulation for acute occlusion of a peripheral artery, it is unclear whether trauma surgeons follow this practice. A survey regarding the use of perioperative anticoagulation was sent to surgeons who perform their own peripheral arterial repairs after traumatic injury to define contemporary practice patterns. This survey demonstrated minimal consensus opinion regarding the management of extremity vascular injuries, strongly suggesting the need for a consensus conference, meta-analysis, and prospective studies to guide further care.
Get full access to this article
View all access options for this article.
References
1.
KonstantinidisA., InabaK., DuboseJ.Vascular trauma in geriatric patients: a national trauma databank review.J Trauma2011; 71: 909–16.
2.
MurrayG.Heparin in surgical treatment of blood vessels.Arch Surg1940; 40: 307–25.
3.
CollinsG.J.Jr., KimballD.B., RichN.M.Heparin utilization during arterial revascularization.Am Surg1978; 44: 753–7.
4.
EffeneyD.J., GoldstoneJ., ChinD.Intraoperative anti-coagulation in cardiovascular surgery.Surgery1981; 90: 1068–74.
HumphriesM., BlumeM.K., RodriguezM.C.Outcomes after anticoagulation for traumatic arterial injuries of the extremity.JAMA Surg2016; 151: 986–7.
8.
LojaM.N., GalanteJ.M., HumphriesM.Systemic anti-coagulation in the setting of vascular extremity trauma.Injury2017; 48: 1911–6.
9.
SidawayA.N., PerlerB.A.Rutherford's Vascular Surgery and Endovascular Therapy.Philadelphia, PA: Elsevier, 2019.
10.
NorgrenL., HiattW.R., DormandyJ.A.Inter-society consensus for the management of peripheral arterial disease (TASC II).J Vasc Surg2007; 45: S5–67.
11.
Gerhard-HermanM.D., GornikH.L., BarrettC.2016 AHA/ACC guideline on the management of patients with lower extremity peripheral artery disease: executive summary.Vasc Med2017; 22: NP1–43.
12.
FoxN., RajaniR.R., BokhariF.Evaluation and management of penetrating lower extremity arterial trauma: an Eastern Association for the Surgery of Trauma practice management guideline.J Trauma Acute Care Surg2012; 73: S315–20.
13.
FelicianoD.V.Pitfalls in the management of peripheral vascular injuries.Trauma Surg Acute Care Open2017; 2: e000110.
14.
HausenloyD.J., YellonD.M.Ischaemic conditioning and reperfusion injury.Nat Rev Cardiol2016; 13: 193–209.
15.
FallujiN., MukherjeeD.Critical and acute limb ischemia: an overview.Angiology2014; 65: 137–46.
16.
WangS.K., MurphyM.P., GutweinA.R.Perioperative outcomes are adversely affected by poor pretransfer adherence to acute limb ischemia practice guidelines.Ann Vasc Surg2018; 50: 46–51.
17.
RutherfordR.B., BakerJ.D., ErnstC.Recommended standards for reports dealing with lower extremity ischemia: revised version.J Vasc Surg1997; 26: 517–38.
LojaM.N., SammannA., DuBoseJ.The mangled extremity score and amputation: time for a revision.J Trauma Acute Care Surg2017; 82: 518–23.
20.
ScaleaT.M., DuBoseJ., MooreE.E.Western Trauma Association critical decisions in trauma: management of the mangled extremity.J Trauma Acute Care Surg2012; 72: 86–93.
McAvoyT.J.Pharmacokinetic modeling of heparin and its clinical implications.J Pharmacokinet Biopharm1979; 7: 331–54.
23.
HirshJ., van AkenW.G., GallusA.S.Heparin kinetics in venous thrombosis and pulmonary embolism.Circulation1976; 53: 691–5.
24.
ClagettG.P., SobelM., JacksonM.R.Antithrombotic therapy in peripheral arterial occlusive disease: the seventh ACCP conference on antithrombotic and thrombolytic therapy.Chest2004; 126: 609S–26S.
25.
WangE., InabaK., ChoJ.Do antiplatelet and anti-coagulation agents matter after repair of traumatic arterial injuries?Am Surg2016; 82: 968–72.