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Revascularisation of leg

What is a vascular injury?

Injury to the major blood vessels which often need to be repaired to save the limb or other part is called a vascular injury. In the lower limb, they are usually seen in fractures around the knee area. In such cases, the popliteal artery is injured which provides blood supply to the leg.

Why should they be treated?

If blood supply to the leg is lost, the tissues die soon. This eventually leads to gangrene and then the limb needs to be amputated. Blood flow has to be reconnected to save the limb.

How quickly should this be done?

Ideally, blood flow has to be restarted within 6 hours from injury. Sometimes this ‘revascularisation’ procedure may be performed up to 12 hours depending on the status of the muscles. After 12 hours, it is too risky.

What is the risk involved in late revascularisation?

The toxins from dead muscles get back to the body if blood flow is restarted after a long time. This can be life threatening by affecting the heart and the kidneys.

How is Revascularisation done?

The blood vessels cut ends are stitched if possible. Often there is a gap between the ends and this is filled with graft taken from the leg. Anyhow, the goal is to restart blood flow as early and reliably as possible.

How long does it take to recover?

Blood flow is restored immediately, but proper healing of the vessel takes 3 weeks. The total recovery time is decided by the associated fractures.

Angiogram showing lack of blood flow to leg

Knee wound with ischemic leg

Vein grafting of popliteal artery to restore blood flow

After wound healing