Traumatic injuries: imaging and intervention of large arterial trauma

Abstract

Traumatic vessel injury can cause bleeding, thrombosis, embolization, or malperfusion due to external compression and spasm. Non-traumatic causes of acute large arterial emergencies include rupture of an aneurysm and pseudoaneurysm, dissection, embolization, and thrombosis in hypercoagulability syndromes. Ultrasonography is, of course, the imaging modality of choice in emergency cases; however, in central vascular injuries, spiral CT with contrast enhancement is the imaging modality that provides the most information. Angiography may be necessary for detailed information and before intervention. Stent-grafts are used to close large vascular lacerations, ruptured aortic aneurysms, and the entry tear of dissections. Interventional radiology methods play a major role in managing vascular emergencies.

Management of Vascular Injuries in a Forward Hospital

“…In a patient with such overt signs no special investigation is required, and the patient can be directly wheeled into the operation theatre after recording the doppler pressures [11,12]. Colour doppler imaging has been reported as an investigative modality in stable patients [13], with some authors suggesting this to be the imaging modality of choice [14]. This investigative modality was not available at our hospital.…”

Traumatic extracranial internal carotid-jugular fistula leading to serious injury: a case report in forensic assessment

“…If the lesion of the arterial branch is not too large, the artery may go into spasm and temporarily stop bleeding. In such cases, the injuries are often asymptomatic and may be missed [10,11].…”

Pseudoaneurysm of the dorsalis pedis artery: Color Doppler sonographic and angiographic findings

“…5 Several techniques can be applied to establish the diagnosis of pseudoaneurysms, including gray-scale and duplex Doppler sonography, CT, and angiography. [6][7][8] Although angiography is the best method for detecting vascular pathologies, it is sometimes unable to differentiate an aneurysm from a pseudoaneurysm. 9 In addition, angiography is an invasive method, and patients are exposed to radiation.…”