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Arterial Trauma

- 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:

Ankle–Brachial Index and Peripheral Arterial Disease

Early fasciotomy in patients with extremity vascular injury is associated with decreased risk of adverse limb outcomes: A review of the National Trauma Data Bank

A Proactive Approach to the Coagulopathy of Trauma: The Rationale and Guidelines for Treatment

Surgical Approach to the Pseudoaneurysms of Lower Extremity Arteries Developed After Gunshot Injuries