Management of specific arterial injuries

A total of 542 vascular injuries at 14 centers were treated. The distribution of these injuries and treatment are shown in the table. Hard signs of vascular injury, including hypotension, were noted in 29 percent of patients. A prehospital tourniquet was used for extremity injuries in 20 percent (47 of 233). Nonoperative management was undertaken in 51 percent, with failure in 4.0 percent. Definitive endovascular and open repair were used in 7.4  and 23.2 percent of patients, respectively. Damage-control maneuvers were used in 10.5 percent, including vascular ligation in 5.7 percent and shunting in 2.6 percent. Reintervention of initial repair was required in 7.7 percent. Amputation was performed in 7.7 percent of extremity vascular injuries, and overall hospital mortality was 12.7 percent.