The Natural History of Clinically Occult Arterial Injuries

Frykberg, Eric R.; Vines, Frederick S.; Alexander, Raymond H.

doi:10.1097/00005373-198905000-00006

Cited by 113 publications

(38 citation statements)

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“…22 Controversially, 1 old prospective study of 20 arterial injuries, including 1 pseudoaneurysm, managed without surgery suggested nonoperative observation may be a safe and feasible method of managing clinically occult arterial injuries. 27 On review of the literature summarized above, we would recommend an endovascular approach is particularly useful for pseudoaneurysms in difficult access vessels such as the subclavian arteries. Primary open surgical approach is useful for easier to access vessels such SFA pseudoaneurysms; however, open surgery is also important in management of failed endovascular ablations.…”

Section: Discussionmentioning

confidence: 99%

Three-Year Delayed Presentation of Femoral Pseudoaneurysm after Penetrating Limb Trauma

Butterworth

2015

Annals of Vascular Surgery

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Section: Discussionmentioning

confidence: 99%

Three-Year Delayed Presentation of Femoral Pseudoaneurysm after Penetrating Limb Trauma

Butterworth

2015

Annals of Vascular Surgery

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“…Although the clinical significance of these 'minor' lesions may be controversial, studies show that many of these lesions either resolve or remain asymptomatic. 10 The small vertebral artery aneurysm was managed conservatively and therefore no significant management difference occurred.…”

Section: Discussionmentioning

confidence: 99%

A retrospective study of computed tomography angiography versus digital subtraction angiography in penetrating neck trauma at Groote Schuur Hospital, South Africa

2014

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Background: Penetrating neck trauma is commonly encountered in South African trauma units, and is associated with high mortality and morbidity rates. The imaging protocol for stable patients with penetrating neck trauma remains controversial. There is only sparse data validating the use of computed tomography angiography (CTA) in the evaluation of penetrating neck trauma in South Africa.Objectives: To assess the sensitivity and specificity of CTA versus digital subtraction angiography (DSA) in detecting arterial injury and secondarily evaluate the ability of CT to assess non-arterial injury.Method: Using hospital and radiology databases, 23 patients were identified who had undergone both CTA and DSA for penetrating neck trauma. The data was retrospectively anonymised and randomised. A radiologist experienced in the interpretation of both trauma CTA and DSA re-reported all the imaging and the findings were compared and analysed.Results: Twenty-four arterial injuries were detected. The sensitivity of CTA for detecting arterial injury was 78% and the specificity 83%. The ability of CTA to delineate wound track and detect non-arterial visceral injury was also confirmed.Conclusion: CTA is an attractive initial diagnostic investigation that, along with clinical evaluation, effectively guides further investigation and intervention. It is important for the radiologist to understand the limitations of CTA and have a low threshold for DSA in equivocal cases.

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“…Published reports demonstrate that many iatrogenic pseudoaneurysms will close spontaneously, and at least one report suggested that most incidentally found vascular injuries are of no consequence. 10,11 We found, however, that many of these patients required operative fixation of jaw and maxillary fractures, and the otolaryngology or oral-maxillofacial surgery services were reluctant to manipulate bone fragments for fear of causing uncontrollable bleeding. 12 After encountering two episodes of massive hemorrhage from these pseudoaneurysms, we altered our treatment protocols to address the pseudoaneurysms as quickly as possible.…”

Section: Discussionmentioning

confidence: 99%