FROM EXSANGUINATION TO RECOVERY: MANAGING TOTAL TRANSECTION OF THE COMMON FEMORAL ARTERY viviennecheah0316@gmail.com

 

FROM EXSANGUINATION TO RECOVERY: MANAGING TOTAL TRANSECTION OF THE COMMON FEMORAL ARTERY

2

Malaysia

Oral or Poster

Traumatic injuries to the common femoral artery are rare but life-threatening due to its critical role in lower limb perfusion. Prompt recognition and timely surgical intervention are essential to prevent exsanguination, limb loss, or death. Vascular reconstruction using polytetrafluoroethylene (PTFE) grafts remains a viable option when primary repair is not feasible, particularly in cases of complete arterial transection.

A 18year old male presented to the emergency department with a large laceration wound at the left groin following a motor vehicle accident. He was hemodynamically stable but tachycardic with a degloving wound size around 12x15cm with exposure of underlying muscle and slow oozing of blood. DPA and PTA was not palpable. He was promptly taken to the operating theatre for wound exploration.

Intraoperative findings revealed a complete transection of the left common femoral artery. Due to the extent of the injury and tissue loss, primary repair was not feasible. A PTFE interposition graft was performed. Post-operatively, the patient developed disseminated intravascular coagulation (DIVC) and required massive transfusion support, along with triple inotropes, over several days before achieving hemodynamic stability. He was subsequently weaned off support with good limb perfusion.

Total transection of the common femoral artery is a surgical emergency requiring rapid diagnosis and intervention. This case underscores the importance of early operative exploration and the utility of PTFE grafting as a limb-saving measure when autologous grafting is not feasible. Awareness and preparedness in managing such vascular injuries are essential in the trauma setting to reduce morbidity and mortality.