Traumatic arterial spasm causing transient limb ischaemia: a genuine clinical entity

Abstract

Traumatic arterial spasm is a phenomenon that has long been questioned by clinicians. Indeed, some would argue that surgical exploration is mandatory whenever there are signs of distal ischaemia following limb trauma. We present a case of angiographically demonstrated tibial artery spasm following gunshot injury. Exploration was unnecessary and distal perfusion was reestablished spontaneously. This case demonstrates the existence of traumatic arterial spasm as a genuine clinical entity and suggests that immediate surgical exploration may not be necessary in all cases.

Posttraumatic Cerebellar Infarction after Repeated Sport-related Minor Head Injuries in a Young Adult: A Case Report

“…Although there remains much contention over the existence of trauma-induced arterial spasm in the absence of arterial wall damage, several reports of traumatic arterial spasm have been reported. 30 , 31) Previous reports of cerebral infarction after minor head injury have reported that rapid time course, recurrent and transient symptoms, and reversible imaging changes are consistent with intermittent arterial spasm. 5 – 7) They would support our hypothesis.…”

Traumatic popliteal artery spasm diagnosed using intraoperative angiography: A case report

“…The general duration of traumatic arterial spasm in large-sized vessels has not been documented in literature. In case reports of arterial spasm in lower extremities due to bullet injuries, arterial spasm disappeared and blood flow in the lower extremities recovered in about 1.5 to 2 h after the injury [ 2 , 4 ]. In our case, CTA performed 3 h after injury confirmed occlusion of the popliteal artery, and intraoperative angiography performed 4 h after injury showed patency of the popliteal artery.…”

“…Vasospasm of the small- or medium-sized arteries, such as the coronary, carotid, and cerebral arteries, has been well documented in the literature. However, there are few reports of traumatic arterial spasm in relatively large-sized vessels in the extremities, and many surgeons are skeptical of its existence [ 2 ]. A review by Samson et al on traumatic vasospasm in the extremities highlighted its existence as a rare but distinct pathophysiological entity [ 3 ].…”

Assessing Soft Tissue Perfusion Using Laser-Assisted Angiography in Tibial Plateau and Pilon Fractures: A Pilot Study

“…Although vascular injuries were excluded from the study sample, it is possible that blunt trauma results in reversible or transient vasospasm of the peripheral arteriole system. 30,31 Thus, the perfusion measured at the time of surgery may not be a true measure of postoperative perfusion during recovery. Finally, given that the SPY technology and ICG dye is associated with a significant cost, this diagnostic tool is currently not widely available at other sites for orthopaedic use.…”