The surgical treatment of arterial injuries in the civilian population.

During an 8-year period, 191 consecutive patients were treated for arterial injuries. Blunt trauma occurred in 46 patients (24%), low velocity gunshot wounds in 82 patients (43%), shotgun wounds in 22 patients (12%), stab wounds in 20 patients (10%), iatrogenic injury in nine patients (5%), high velocity gunshot wounds in two patients (1%) and other penetrating wounds in ten patients (5%). Preoperative arteriography was performed in 48 patients (25%) who were hemodynamically stable with injuries to major vessels in the thorax, base of neck or extremities and in whom the exact location or extent of injury was unknown. Surgical repair was performed in 184 of 191 patients (96%); seven patients expired intraoperatively before reconstruction could take place. Repair was accomplished in the 184 patients by end-to-end primary anastomosis in 80 patients (44%), lateral sutures in 21 patients (11%), SVG in 71 patients (85%) and Dacron prosthesis in 13 patients (15%). One hundred seventy patients survived (89%) and 21 patients died (11%), seven of the 21 deaths were intraoperative and ten others were due to the effects of trauma to the aorta or its branches.