Assessment of Proximity of a Wound to Major Vascular Structures as an Indication for Arteriography

Reid, John D.; Weigelt, John A.; Thal, Erwin R.; Francis, Hugh

doi:10.1001/archsurg.1988.01400320028004

Cited by 83 publications

(20 citation statements)

References 24 publications

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“…Nonetheless, among these suspicious cases, the results of angiographies have been normal or near normal and even a small defect might be noted, which would not change the management course of such cases with trauma (5). Hence, many have tried to substitute angiography with noninvasive modalities such as serial physical examination alone or in combination with other methods including ankle brachial index (ABI), arterial pressure index (API) or Doppler ultrasonography (USG) (6)Color Doppler USG is a noninvasive method widely used for the diagnosis of vascular diseases because of its acceptable accuracy in detection of vascular lesions (7). …”

Section: Introductionmentioning

confidence: 99%

Comparing Color Doppler Ultrasonography and Angiography to Assess Traumatic Arterial Injuries of the Extremities

et al. 2014

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Background:Traumatic events are one of the major causes of arterial injuries. Physical examination is not a good predictor of the extent of injuries and arteriography is considered as the gold standard for this purpose. In the recent years, noninvasive modalities are increasingly replacing diagnostic arteriography. Color Doppler ultrasonography (USG) is an excellent method to investigate arterial diseases.Objectives:The present study aimed to evaluate the diagnostic value of color Doppler USG compared to conventional angiography in traumatic arterial injuries of extremities.Patients and Methods:Seventy-five patients with extremity trauma suspicious for arterial injury were examined by color Doppler USG just before angiography. Doppler pattern and flow states were assessed, then angiography was performed. The results of duplex USG were compared with angiography.Results:Color Doppler USG had a sensitivity of 95% and specificity of 98% in diagnosis of arterial injury. Positive and negative predictive values of Doppler USG were 92.5% and 94.2%, respectively.Conclusions:Color Doppler USG can be used as a reliable modality with acceptable sensitivity and specificity values to screen hemodynamically stable patients with limb trauma suspicious for arterial injury.

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Section: Introductionmentioning

confidence: 99%

Comparing Color Doppler Ultrasonography and Angiography to Assess Traumatic Arterial Injuries of the Extremities

et al. 2014

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“…8,9 The role of emergency arteriography in these patients is not well defined. 5,7,[9][10][11][15][16][17] In our series emergency arteriography was performed in all stable patients who arrived at the ER with a penetrating wound proximate to a major vascular artery.…”

Section: Discussionmentioning

confidence: 99%

Emergency Arteriography in the Assessment of Penetrating Trauma to the Lower Limbs

Jebara¹,

Haddad

Ghossain

et al. 1991

Angiology

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One hundred emergency arteriographies (EA) were performed in 87 patients with lower limb trauma due to high-velocity missiles. Thirteen patients had bilateral injuries. In 79 cases, EA findings were positive and led to emergency surgery. In 76 cases an arterial injury was found and treated, a positive predictive value of 96% (76/79). In the other 3 cases, no arterial lesion was found (3 false positives). Among the 21 patients with normal findings from angiography, 10 had surgical exploration because of high clinical suspicion of vascular injury. Arterial injury was found in 2 cases (2 false negatives). In 8 patients, arteriography modified the surgical procedure. In the 11 remaining patients, clinical and echo Doppler follow-up results were normal, a negative predictive value of 90% (19/21). Sensitivity was 97%, specificity 86%, and accuracy 95%. These data show that arteriography in stable patients is a safe and accurate procedure. It permits avoidance of unnecessary surgical exploration in selected patients and helps modify the surgical procedure.

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“…Plastic tubes that can be used as temporary intravascular shunts include the following: Argyle carotid artery shunts (8)(9)(10)(11)(12)(13)(14) and thoracostomy tubes (Sherwood Medical, St Louis, Missouri, USA); the Javid Carotid Bypass Shunt (17 Fr; Bard Implants Division, Billerica, Massachusetts, USA); and the Pruitt-Inahara Carotid Shunt (9 Fr; Ideas for Medicine, St Petersburg, Florida, USA). The shunt chosen is inserted after resection of the injured segment of a peripheral artery (or vein) and is held in place by 2-0 silk ties (Argyle), special clamps (Javid), or by inflatable balloons at either end of the shunt (Pruitt-Inahara).…”

Section: Endovascular Managementmentioning

confidence: 99%

Management of peripheral arterial injury

Feliciano

2010

Current Opinion in Critical Care

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Assessment of Proximity of a Wound to Major Vascular Structures as an Indication for Arteriography

Cited by 83 publications

References 24 publications

Comparing Color Doppler Ultrasonography and Angiography to Assess Traumatic Arterial Injuries of the Extremities

Comparing Color Doppler Ultrasonography and Angiography to Assess Traumatic Arterial Injuries of the Extremities

Emergency Arteriography in the Assessment of Penetrating Trauma to the Lower Limbs

Management of peripheral arterial injury

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