{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T14:04:44Z","timestamp":1793196284039,"version":"4.5.0"},"reference-count":39,"publisher":"FapUNIFESP (SciELO)","license":[{"start":{"date-parts":[[2023,1,1]],"date-time":"2023-01-01T00:00:00Z","timestamp":1672531200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2023,1,1]],"date-time":"2023-01-01T00:00:00Z","timestamp":1672531200000},"content-version":"am","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2023,1,1]],"date-time":"2023-01-01T00:00:00Z","timestamp":1672531200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. vasc. bras."],"abstract":"<jats:p>Abstract  Background Lower limbs are frequently involved in vascular trauma, but it is still not clear which factors lead to unfavorable clinical outcomes.  Objectives To determine the clinical profile of patients with femoropopliteal injuries, the trauma mechanisms, and treatment and identify which factors led to unfavorable outcomes.  Methods A retrospective study based on the medical records of patients treated from 2017 to 2021. The following data were assessed: sex, age, distance to reach the hospital, trauma mechanism, hypovolemic shock, additional injuries, treatment of vascular injuries, whether fasciotomy was needed, inappropriate intraoperative decisions, and injury severity score. Need for surgical reintervention, amputation, and death were defined as unfavorable outcomes. Univariate, bivariate, and logistic regression analyses were conducted.  Results The sample comprised 94 patients; 83% were men; mean age was 30.8 years; combined arterial and venous injuries prevailed (57.5%); and superficial femoral vessels were the most affected (61.7%). Penetrating mechanisms prevailed (80.9%). Arterial injuries were most frequently treated with venous graft (59.6%) and venous injuries underwent ligation (81.4%). In 15% of cases, inappropriate surgical decisions were detected; most often use of the ipsilateral great saphenous vein for arterial reconstruction. Unfavorable outcomes occurred in 44.7%: surgical reintervention was necessary in 21.3% and limb amputation in 25.5%, while 9.5% of the patients died.  Conclusions These injuries mainly involved young men, victims of gunshot wounds. Superficial femoral vessels were the most injured; concomitant non-vascular trauma was frequent, mainly fractures. Inappropriate surgical decisions increased the need for reinterventions by 34 times. Need for fasciotomy, presence of fracture\/dislocation, blunt trauma mechanism, and popliteal artery injury increased the risk of amputation.<\/jats:p>","DOI":"10.1590\/1677-5449.202300502","type":"journal-article","created":{"date-parts":[[2023,11,13]],"date-time":"2023-11-13T11:09:17Z","timestamp":1699873757000},"source":"Crossref","is-referenced-by-count":1,"title":["Prognostic factors for femoropopliteal vascular injuries: surgical decisions matter"],"prefix":"10.1590","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9345-9539","authenticated-orcid":false,"given":"Adenauer Marinho de Oliveira","family":"G\u00f3es Junior","sequence":"first","affiliation":[{"name":"Universidade Federal do Par\u00e1,  Brasil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fernanda Beatriz Ara\u00fajo de","family":"Albuquerque","sequence":"additional","affiliation":[{"name":"Universidade Federal do Paran\u00e1,  Brasil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matheus Oliveira","family":"Feij\u00f3","sequence":"additional","affiliation":[{"name":"For\u00e7a A\u00e9rea Brasileira,  Brasil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4401-3893","authenticated-orcid":false,"given":"Fl\u00e1via Beatriz Ara\u00fajo de","family":"Albuquerque","sequence":"additional","affiliation":[{"name":"Ex\u00e9rcito Brasileiro,  Brasil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luciana Roberta do Vale","family":"Corr\u00eaa","sequence":"additional","affiliation":[{"name":"Hospital Metropolitano de Urg\u00eancia e Emerg\u00eancia,  Brasil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariseth Carvalho de","family":"Andrade","sequence":"additional","affiliation":[{"name":"Funda\u00e7\u00e3o Santa Casa de Miseric\u00f3rdia do Par\u00e1,  Brasil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"530","published-online":{"date-parts":[[2023]]},"reference":[{"issue":"4","key":"ref1","article-title":"Vascular trauma in the Amazon: updating the challenge","volume":"45","author":"G\u00f3es Jr AMO","year":"2018","journal-title":"Rev Col Bras Cir"},{"issue":"6","key":"ref2","doi-asserted-by":"crossref","first-page":"1197","DOI":"10.1097\/TA.0000000000002968","article-title":"American Association for the Surgery of Trauma-World Society of Emergency Surgery guidelines on diagnosis and management of abdominal vascular injuries","volume":"89","author":"Kobayashi L","year":"2020","journal-title":"J Trauma Acute Care Surg"},{"issue":"2","key":"ref3","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1097\/TA.0000000000000520","article-title":"The American Association for the Surgery of Trauma PROspective Observational Vascular Injury Treatment (PROOVIT) registry: multicenter data on modern vascular injury diagnosis, management, and outcomes","volume":"78","author":"DuBose JJ","year":"2015","journal-title":"J Trauma Acute Care Surg"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"342","DOI":"10.1016\/j.avsg.2019.06.037","article-title":"Operative treatment and clinical outcomes in peripheral vascular trauma: the combined experience of two centers in the endovascular era","volume":"62","author":"D\u2019Alessio I","year":"2020","journal-title":"Ann Vasc Surg"},{"issue":"3","key":"ref5","doi-asserted-by":"crossref","first-page":"804","DOI":"10.1016\/j.jvs.2021.02.015","article-title":"Popliteal scoring assessment for vascular extremity injuries in trauma study","volume":"74","author":"O\u2019Banion LA","year":"2021","journal-title":"J Vasc Surg"},{"issue":"4","key":"ref6","doi-asserted-by":"crossref","first-page":"621","DOI":"10.1007\/s00590-020-02818-9","article-title":"Association of trauma severity scores with limb amputation and death in acute leg compartment syndrome","volume":"31","author":"Zhang D","year":"2021","journal-title":"Eur J Orthop Surg Traumatol"},{"issue":"9","key":"ref7","doi-asserted-by":"crossref","first-page":"1893","DOI":"10.1111\/ans.17002","article-title":"The epidemiology and outcomes of vascular trauma in Gold Coast, Australia: Institutional experience at a level 1 trauma centre","volume":"91","author":"Weller J","year":"2021","journal-title":"ANZ J Surg"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1016\/j.jss.2020.10.017","article-title":"Early fasciotomy and limb salvage and complications in military lower extremity vascular injury","volume":"260","author":"Kauvar DS","year":"2021","journal-title":"J Surg Res"},{"issue":"2S","key":"ref9","doi-asserted-by":"crossref","first-page":"S225","DOI":"10.1097\/TA.0000000000002755","article-title":"Management and outcomes of wartime cervical carotid artery injury","volume":"89","author":"White PW","year":"2020","journal-title":"J Trauma Acute Care Surg"},{"issue":"1","key":"ref10","doi-asserted-by":"crossref","first-page":"16199","DOI":"10.1038\/s41598-020-73238-2","article-title":"Vertebral artery injury in major trauma patients in Saudi Arabia: a retrospective cohort study","volume":"10","author":"Chowdhury S","year":"2020","journal-title":"Sci Rep"},{"issue":"5","key":"ref11","doi-asserted-by":"crossref","first-page":"1581","DOI":"10.1016\/j.jvs.2021.04.065","article-title":"Intraoperative consultation of vascular surgeons is increasing at a major American trauma center","volume":"74","author":"Hemingway JF","year":"2021","journal-title":"J Vasc Surg"},{"issue":"4","key":"ref12","doi-asserted-by":"crossref","first-page":"1298","DOI":"10.1016\/j.jvs.2019.12.036","article-title":"Lower extremity vascular injuries caused by firearms have a higher risk of amputation and death compared with non-firearm penetrating trauma","volume":"72","author":"Siracuse JJ","year":"2020","journal-title":"J Vasc Surg"},{"issue":"3","key":"ref13","doi-asserted-by":"crossref","first-page":"318","DOI":"10.1097\/00000658-194909000-00010","article-title":"Quantitative studies on the time factor in arterial injuries","volume":"130","author":"Miller HH","year":"1949","journal-title":"Ann Surg"},{"issue":"3","key":"ref14","doi-asserted-by":"crossref","first-page":"710","DOI":"10.1016\/j.avsg.2013.10.005","article-title":"To shunt or not to shunt? An experimental study comparing temporary vascular shunts and venous ligation as damage control techniques for vascular trauma","volume":"28","author":"G\u00f3es Jr AMO","year":"2014","journal-title":"Ann Vasc Surg"},{"key":"ref15","doi-asserted-by":"crossref","first-page":"214","DOI":"10.1016\/j.avsg.2016.10.031","article-title":"Venous shunt versus venous ligation for vascular damage control: the immunohistochemical evidence","volume":"41","author":"G\u00f3es Jr AMO","year":"2017","journal-title":"Ann Vasc Surg"},{"issue":"2","key":"ref16","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1016\/j.cps.2021.01.005","article-title":"Lower extremity reconstruction for limb salvage and functional restoration: the combat experience","volume":"48","author":"McCulloch I","year":"2021","journal-title":"Clin Plast Surg"},{"issue":"4","key":"ref17","doi-asserted-by":"crossref","first-page":"1304","DOI":"10.1016\/j.jvs.2020.08.137","article-title":"Temporary intravascular shunt use improves early limb salvage after extremity vascular injury","volume":"73","author":"Polcz JE","year":"2021","journal-title":"J Vasc Surg"},{"issue":"8","key":"ref18","article-title":"Outcomes of revascularization and factors associated with major amputation in patients with lower limb arterial injury: a single-center retrospective analysis","volume":"13","author":"Ali G","year":"2021","journal-title":"Cureus"},{"issue":"11","key":"ref19","doi-asserted-by":"crossref","first-page":"2524","DOI":"10.1016\/j.injury.2020.07.046","article-title":"Popliteal artery injuries. Less ischemic time may lead to improved outcomes","volume":"51","author":"Asensio JA","year":"2020","journal-title":"Injury"},{"issue":"3","key":"ref20","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1024\/0301-1526\/a000849","article-title":"In-hospital outcomes of patients with non-iatrogenic civilian vascular trauma","volume":"49","author":"Meyer A","year":"2020","journal-title":"Vasa"},{"key":"ref21","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1016\/j.avsg.2021.05.007","article-title":"Management and outcomes after upper versus lower extremity vascular trauma","volume":"76","author":"Gallo LK","year":"2021","journal-title":"Ann Vasc Surg"},{"issue":"3","key":"ref22","doi-asserted-by":"crossref","first-page":"814","DOI":"10.1016\/j.jvs.2021.02.023","article-title":"Endovascular versus open repair of isolated superficial femoral and popliteal artery injuries","volume":"74","author":"Potter HA","year":"2021","journal-title":"J Vasc Surg"},{"key":"ref23","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1016\/j.avsg.2020.05.069","article-title":"Outcomes of popliteal artery injuries repair: autologous vein versus prosthetic interposition grafts","volume":"69","author":"Rehman ZU","year":"2020","journal-title":"Ann Vasc Surg"},{"key":"ref24","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1016\/j.avsg.2019.05.007","article-title":"Analysis of Limb Outcomes by Management of Concomitant Vein Injury in Military Popliteal Artery Trauma","volume":"62","author":"Guice JL","year":"2020","journal-title":"Ann Vasc Surg"},{"key":"ref25","series-title":"Vascular extremity trauma","author":"Huber GH","year":"2023"},{"key":"ref26","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1016\/j.jss.2020.08.015","article-title":"A nationwide analysis of popliteal vascular injuries and outcomes by hospital teaching status","volume":"257","author":"Elkbuli A","year":"2021","journal-title":"J Surg Res"},{"issue":"6","key":"ref27","doi-asserted-by":"crossref","first-page":"2064","DOI":"10.1016\/j.jvs.2020.12.050","article-title":"Four-year outcomes following endovascular repair in patients with traumatic isolated popliteal artery injuries","volume":"73","author":"Jiang C","year":"2021","journal-title":"J Vasc Surg"},{"issue":"3","key":"ref28","doi-asserted-by":"crossref","first-page":"437","DOI":"10.1016\/j.jvsv.2019.09.014","article-title":"Impact of ligation versus repair of isolated popliteal vein injuries on in-hospital outcomes in trauma patients","volume":"8","author":"Byerly S","year":"2020","journal-title":"J Vasc Surg Venous Lymphat Disord"},{"issue":"3","key":"ref29","doi-asserted-by":"crossref","first-page":"e62","DOI":"10.1097\/TA.0000000000003316","article-title":"Review article: History of venous trauma","volume":"91","author":"Feliciano DV","year":"2021","journal-title":"J Trauma Acute Care Surg"},{"key":"ref30","series-title":"Soci\u00e9t\u00e9 Fran\u00e7aise d\u2019Anesth\u00e9sie et de R\u00e9animation","year":"2023"},{"issue":"2","key":"ref31","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1097\/JTN.0000000000000567","article-title":"Comparison of trauma severity scores (ISS, NISS, RTS, BIG Score, and TRISS) in multiple trauma patients","volume":"28","author":"H\u00f6ke MH","year":"2021","journal-title":"J Trauma Nurs"},{"issue":"2","key":"ref32","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1080\/10903127.2018.1489019","article-title":"Correlation between the revised trauma score and injury severity score: implications for prehospital trauma triage","volume":"23","author":"Galvagno Jr SM","year":"2019","journal-title":"Prehosp Emerg Care"},{"key":"ref33","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1016\/j.avsg.2020.05.007","article-title":"Vascular surgeons carry an increasing responsibility in the management of lower extremity vascular trauma","volume":"70","author":"Parihar S","year":"2021","journal-title":"Ann Vasc Surg"},{"issue":"1","key":"ref34","doi-asserted-by":"crossref","DOI":"10.1136\/tsaco-2020-000468","article-title":"Venous thromboembolism after penetrating femoral and popliteal artery injuries: an opportunity for increased prevention","volume":"5","author":"Ratnasekera A","year":"2020","journal-title":"Trauma Surg Acute Care Open"},{"key":"ref35","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1016\/j.jss.2021.03.039","article-title":"Traumatic femoral artery injuries and predictors of compartment syndrome: a nationwide analysis","volume":"265","author":"Asmar S","year":"2021","journal-title":"J Surg Res"},{"issue":"4","key":"ref36","doi-asserted-by":"crossref","first-page":"244","DOI":"10.1590\/0100-69912015004009","article-title":"Vascular trauma in the Amazon: the challenge of great distances","volume":"42","author":"G\u00f3es Jr AM","year":"2015","journal-title":"Rev Col Bras Cir"},{"issue":"6824","key":"ref37","doi-asserted-by":"crossref","first-page":"439","DOI":"10.1136\/bmj.304.6824.439","article-title":"ABC of vascular diseases","volume":"304","author":"Mansfield AO","year":"1992","journal-title":"BMJ"},{"issue":"6","key":"ref38","doi-asserted-by":"crossref","first-page":"1389","DOI":"10.1007\/s00268-014-2865-8","article-title":"Penetrating extremity trauma","volume":"39","author":"Ivatury RR","year":"2015","journal-title":"World J Surg"},{"issue":"12","key":"ref39","doi-asserted-by":"crossref","first-page":"1077","DOI":"10.1002\/bjs.1800741204","article-title":"Vascular trauma","volume":"74","author":"Blacklay PF","year":"2005","journal-title":"Br J Surg"}],"container-title":["Jornal Vascular Brasileiro"],"original-title":["Fatores progn\u00f3sticos em traumatismos vasculares do segmento femoropopl\u00edteo: decis\u00f5es intraoperat\u00f3rias s\u00e3o importantes"],"link":[{"URL":"http:\/\/www.scielo.br\/scielo.php?script=sci_pdf&pid=S1677-54492023000100318&tlng=en","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,13]],"date-time":"2023-11-13T11:09:52Z","timestamp":1699873792000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.scielo.br\/scielo.php?script=sci_arttext&pid=S1677-54492023000100318&tlng=en"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023]]},"references-count":39,"alternative-id":["S1677-54492023000100318"],"URL":"https:\/\/doi.org\/10.1590\/1677-5449.202300502","relation":{"has-translation":[{"id-type":"doi","id":"10.1590\/1677-5449.202300501","asserted-by":"subject"}]},"ISSN":["1677-7301","1677-5449"],"issn-type":[{"value":"1677-7301","type":"electronic"},{"value":"1677-5449","type":"print"}],"subject":[],"published":{"date-parts":[[2023]]},"article-number":"e20230050"}}