- See:
-
Artery Menu
-
Arterial Injuries Associated with Fractures
-
Pharmocological Agents in Vascular Surgery:
-
Technique of Microanatomosis:
- Arteriography:
- Types of Injuries:
-
intimal injuries:
- nonsevered artery:
- results from blunt force or stretch, may follow passage of missle;
- results in loss or reduction of flow w/o external signs of bleeding;
- ischemia is variable, may deveop w/ time & requires serial exam;
- subintimal dissection may occur lifting flap that occludes lumen;
- intraluminal hematoma may form that obliterates lumen of artery;
-
venous repair
- Exam:
- important to recognize that many arteries do not have distal point for palpating pulsations;
- common and internal carotid, internal iliac,
profunda femoris, and
peroneal arteries defy examination;
- w/ arterial trauma to leg or forearm, consider temporarily occluding one distal artery, inorder to assess patency of the other;
- in the forearm, occlude the ulnar artery inorder to assess patency of radial artery (and vice versa);
- in the leg, occlude dorsalis pedis artery inorder to assess patency of posterior tibial artery (and vice versa);
- rapid expansion of a large pulsatile hematoma;
- presence of systolic or continuous bruit in the region of an injury;
- marked venous distension of the injured extremity;
- Anatomy:
-
anastomosis of lower limb arteries
-
anastomosis of upper limb arteries
- Management Considerations:
-
arterial injuries associated with fractures
-
reperfusion injury
-
compartment syndrome:
-
fasciotomy of the leg:
-
fasciotomy of the forearm
- Technique of Microanatomosis:
- References:
A PROACTIVE APPROACH TO THE COAGULOPATHY OF TRAUMA: THE RATIONALE AND GUIDELINES FOR TREATMENT
