- See:
-
Arterial Injuries Assoc. w/ Fractures:
-
Arterial Trauma:
-
Femoral Arteriogram:
-
Upper Extremity Arteriogram of the Limbs :
- Discussion:
- pts w/ obvious signs of vascular injury, such as rapid external
bleeding, an expanding hematoma, signs of distal ischemia, or
palpable thrill, are taken to OR for immediate operation;
- pts w/ suspected injury to a great vessel other than subclavian artery
undergo formal arteriography in a radiology suite;
- all other pts w/ suspected peripheral vascular injuries undergo
immediate arteriography by a surgical resident in ER;
- Minor Findings:
- spasm
- obstruction of a minor branch vessel
- arterial displacement by hematoma
- Major Findings:
- intimal flap or dissection
- extravasation
- occlusion
- pseudoaneurysm
- acute arteriovenous fistula
- Technical Considerations:
- r/o renal insufficiency;
-
Femoral Arteriogram:
- thin walled, 18 gauge, 5.23 cm Cournand disposable needle is inserted
either proximal (as in the common femoral artery for superficial
femoral artery studies) or distal (as in retrograde
axillosubclavian artery studies) to the area of suspected injury;
- depending on artery being evaluated, single rapid hand injection of
25 to 50 ml of 30 % meglumine diatrizoate dye is carried out
and a single radiograph obtained;
------------------
Trauma of the extremities: prospective comparison of digital and
conventional angiography.
Vascular proximity: is it a valid indication for arteriography in
asymptomatic patients
O'Gorman, R. B., and Feliciano, D. V.: Arteriography
performed in the emergency center. Am. J. Surg. 152:323, 1986.
Can
Can Doppler pressure measurement replace "exclusion" arteriography in the
diagnosis of occult extremity arterial trauma .
Non-invasive vascular tests reliably exclude occult arterial trauma in
injured extremities.
