1988
DOI: 10.1067/mva.1988.avs0080112
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Limited role of arteriography in penetrating neck trauma

Abstract: Of the patients with penetrating neck wounds treated between 1979 and 1986, 61 patients with 65 injuries had arteriography during their evaluation. Twenty-seven patients had stab wounds and 34 had gunshot wounds, with a relatively equal distribution between the zones of injury. Fifty-seven arteriograms were normal and six were abnormal. Of the six arteriographic defects, three were thought to be spurious on subsequent review, two were clinically insignificant, and one required surgery. No significant arterial … Show more

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Cited by 11 publications
(13 citation statements)
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“…Clinical examination has a low (61%) sensitivity [1]. The use of routine screening angiography has been challenged because of the high number of negative examinations [2,3], and routine surgical exploration has been largely abandoned because of the high morbidity rate [4]. Recently, more noninvasive and rapid screening techniques have been introduced.…”
mentioning
confidence: 99%
“…Clinical examination has a low (61%) sensitivity [1]. The use of routine screening angiography has been challenged because of the high number of negative examinations [2,3], and routine surgical exploration has been largely abandoned because of the high morbidity rate [4]. Recently, more noninvasive and rapid screening techniques have been introduced.…”
mentioning
confidence: 99%
“…18 The use of angiography for stable patients with penetrating neck trauma also has been questioned because of the reported low yield (range, 10 -30%). 12,19,20 In the recent years, there has been a renewed interest in examining the role of noninvasive techniques such as color Doppler sonography, 21-26 magnetic resonance angiography, [27][28][29][30][31][32][33] and helical computed tomographic angiography (HCTA) 9,16,34 -39 for the assessment of vascular neck injuries.…”
mentioning
confidence: 99%
“…Rivers and colleagues reported the limited role and unnecessary use of AG in penetrating trauma to all three zones, including 21 patients with zone 3 injuries. 4 Although five arteriographic abnormalities are found in these 21 patients, patient management is not influenced by these findings. Biffl and colleagues, with one of the largest series, managed 35 of 49 zone 3 penetrating injuries nonoperatively.…”
Section: Discussionmentioning
confidence: 94%
“…16 Recently, several articles have demonstrated the safety and reliability of physical examination alone in detecting zone 2 vascular injuries that require treatment. [4][5][6][7][17][18][19] In extrapolating this approach to zone 3, there are two major differences. First, the area is not as readily evaluated by physical examination; however, this is balanced against the second fact that any type of abnormality identified by AG is usually much more technically demanding to repair.…”
Section: Discussionmentioning
confidence: 99%
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