**6. Natural history and treatment**

Natural history of FTA could be distal embolization (figure 9), rupture (figure 10), neurogenic compression or venous (figure 11) and cardiac failure. These lesions require prompt treatment. The treatment is relatively simple if the interval between injury and operation is not long [8,14,25-31]. Primary arterial repair without grafting is usually not feasible in late-presenting cases owing to the chronic nature of the FTA and the presence of fibrosis and inflammation. In the case of a small aneurysm, resection and primary end-toend repair can be the safest alternative, although some advocate graft interposition [32]. The material of choice for repair is autologous saphenous vein [8,26,28-32]. The use of synthetic grafts is not recommended during the early phase because of infection. Synthetic grafts should be used only for a chronic FTA that involves large arteries (e.g., common femoral, subclavian).

**Figure 9.** Embolization FAA and severe right foot ischemia after femoropopliteal reconstruction

**Figure 10.** Rare case of ruptured FTA after blunt injury in right gluteal reg.

**Figure 9.** Embolization FAA and severe right foot ischemia after femoropopliteal reconstruction

**Figure 10.** Rare case of ruptured FTA after blunt injury in right gluteal reg.

**Figure 11.** FTA of left axillar artery; neurogenic and venous compression

According to some, endovascular procedures can be important in the management of critically injured patients, as well as those with chronic FTA [33-43]. Endovascular repair of a peripheral FTA seems attractive because it theoretically results in less morbidity and shorter hospitalization [33]. However, this experience is still limited, especially in young patients. There is also skepticism regarding the use of stents in the popliteal artery. The reason is the mobility of the knee joint. Because of their history of numerous complications, FTAs require prompt treatment. The treatment is simpler if there is not an extended interval between the injury and the operation. Endovascular repair is mostly indicated in locations where a surgical approach is not easily attained.
