Posterior Tibial Artery Bypass for Iliofemoral Artery Injury Associated With Massive Blood Loss and Shock

Traumatic Disruption of Iliofemoral Arterial Segment is Often Associated With Multiple Injuries, Massive Hemorrhage, State of Shock, and Loss of Blood Supply to the Ipsilateral Lower Extremity, as Well as With High Mortality

Traumatic disruption of iliofemoral arterial segment is often associated with multiple injuries, massive hemorrhage, state of shock, and loss of blood supply to the ipsilateral lower extremity, as well as with high mortality.

The investigators describe a bypass technique. It can provide adequate blood supply to the lower extremity of the injury side. Due to a minimum amount of additional blood loss, it is a low risk procedure for salvage of the extremity and even patient's life.

Study Overview

• Status: Completed
• Conditions: Shock; Iliofemoral Artery Injury

Detailed Description

Patients were selected on the basis of the following: (1) closed injuries to the lower abdomen and/or pelvis; (2) serious hemorrhagic shock; (3) loss of blood supply to the ipsilateral lower extremity; (4) high-risk emergency artery reconstruction.

The instruments used to measure sensibility of the foot were the Semmes-Weinstein (SW) monofilament test 24 and the static two-point discrimination (2PD) test 25. The weight-bearing area of the first metatarsal head and the dorsum of the first metatarsal head were assessed. Active range of motion (ROM) of the hip, knee, and ankle joints was measured with a goniometer. The muscle strength was test using Medical Research Council (MRC) Scale. The cold intolerance of the leg was measured using the self-administered Cold Intolerance Severity Score (CISS) questionnaire 26. The maximum score is 100 and is grouped into 4 ranges (0-25, 26-50, 51-75, and 76-100) corresponding to mild, moderate, severe, and extreme severity, respectively.

• Study Type: Observational
• Enrollment (Actual): 8

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 20 years to 60 years (Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

8 patients

Description

Inclusion Criteria:

1. closed injuries to the lower abdomen and/or pelvis;
2. serious hemorrhagic shock;
3. loss of blood supply to the ipsilateral lower extremity;
4. high-risk emergency artery reconstruction.

Exclusion Criteria:

1. bleeding can be easily control through an open wound;
2. mild shock without life threatening conditions;
3. good blood supply to the ipsilateral lower extremity;
4. low-risk emergency artery reconstruction.

Study Plan

How is the study designed?

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort
8; 8 patients

Collaborators and Investigators

• Sponsor: The Second Hospital of Qinhuangdao
• Investigators: Study Chair: Xu Zhang, MD, The Second Hospital of Qinhuangdao

Study record dates

Study Major Dates

• Study Start: January 1, 2009
• Primary Completion (Actual): January 1, 2009
• Study Completion (Actual): January 1, 2009

Study Registration Dates

• First Submitted: May 9, 2009
• First Submitted That Met QC Criteria: May 11, 2009
• First Posted (Estimate): May 13, 2009

Study Record Updates

• Last Update Posted (Estimate): May 13, 2009
• Last Update Submitted That Met QC Criteria: May 11, 2009
• Last Verified: May 1, 2009

More Information

Terms related to this study

• Keywords: Shock; Reconstruction; Posterior tibial artery bypass; Iliofemoral artery injury
• Additional Relevant MeSH Terms: Pathologic Processes; Wounds and Injuries; Shock
• Other Study ID Numbers: SHQ-0905-A