Devastating distal arterial trauma and continuous intraarterial infusion of tolazoline

Peck, James J.; Fitzgibbons, Terrence J.; Gaspar, Max R.

doi:10.1016/0002-9610(83)90091-0

Cited by 13 publications

(1 citation statement)

References 22 publications

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“…50 When limb loss seems inevitable, a trial of intra-arterial tolazoline is justified. 51 Similarly, intra-arterial papaverine infusion has been used successfully in the management of post-traumatic arterial vasospasm (Fig. 4).…”

Section: Intra-arterial Vasodilator Therapymentioning

confidence: 99%

Angiography and Endovascular Intervention for Vascular Trauma to the Extremities

Murthy¹,

Hastings

Richard

et al. 2003

Semin intervent Radiol

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Vascular trauma to the extremities is less frequently lethal and more commonly penetrating than thoracoabdominal trauma. Arteriography is indispensable in the evaluation of stable patients with hard physical findings or a positive finding on one of a growing variety of noninvasive diagnostic modalities. However, it is not indicated in unstable patients with obvious vascular injury and it is controversial when used in patients with soft findings or simply a penetrating injury in close proximity to a major vascular structure. Arteriography provides access for an increasing array of endovascular treatment options. Embolization can effectively halt bleeding from small-and medium-sized arterial branches where preservation of flow is not crucial. Covered stents and stent grafts can successfully treat lesions in larger arteries where flow must be preserved, but these are offlabel uses where the short-term benefit of avoiding difficult or hazardous surgical access must be weighed against disappointing long-term patency rates, especially when a young patient is involved. Intra-arterial vasodilators can be very useful in patients with critical ischemia due to arterial spasm and local low flow states resulting from severe extremity injuries.Objectives: Upon completion of this article, the reader should understand (1) the natural history of arterial injuries in the extremities, (2) the role of noninvasive evaluation, and (3) the indications for arteriography and endovascular treatment using embolotherapy and endoprostheses. Accreditation: Tufts University School of Medicine (TUSM) is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. TUSM takes responsibility for the content, quality, and scientific integrity of this CME activity. Credit: TUSM designates this educational activity for a maximum of 1 Category 1 credit toward the AMA Physicians Recognition Award. Each physician should claim only those credits that he/she actually spent in the activity.

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Section: Intra-arterial Vasodilator Therapymentioning

confidence: 99%