Abstract
We report two cases of blunt intimal injury of a major artery in the lower extremity treated nonoperatively. A 21-year-old man was injured in a fall and resuscitated. Intimal injury without occlusion of the femoral artery was detected, and he was referred to our institute for vascular reconstruction. Because of intact peripheral circulation and unstable hemodynamics, nonoperative management was preferentially selected. The other patient, a 41-year-old man, suffered damaged knee ligaments. He was referred to our institute because of ischemic limb injury and complete occlusion of the popliteal artery. Examination on admission revealed normal circulation in the injured limb and spontaneous recanalization with the intimal lesion. Nonoperative management was selected because of the lack of need for urgent repair. At the final follow-up of these patients (5.3 years and 2.2 years, respectively), enhanced computed tomography results revealed satisfactory arterial flow without any clinical complications. Nonoperative management can be an alternative when urgent revascularization for acute ischemia is to be performed. There may be an increase in incidences of occult arterial injuries because of recent developments in imaging modalities. Thus, a strategy for intimal injuries of nonocclusive arteries should be established based on analysis of initial images and long-term results.
