Vascular proximity: Is it a valid indication for arteriography in asymptomatic patients?

H. Francis, E. R. Thal, J. A. Weigelt, H. C. Redman

Research output: Contribution to journalArticlepeer-review

48 Scopus citations

Abstract

The role of arteriography in asymptomatic patients with penetrating extremity wounds in proximity to major vessels is controversial. This prospective study was designed to evaluate a precise definition of proximity, determine the incidence of positive arteriograms, and correlate angiographic interpretation with operative findings. Proximity was defined as any wound located within 1 cm of a major vessel. Excluded were patients with a pulse deficit, bruit, thrill, history of arterial hemorrhage, expanding hematoma, nerve deficit, fracture, or significant soft-tissue injury. One hundred sixty arteriograms were performed in 146 patients. One hundred forty-three (89.4%) were true-negatives. Seventeen (10.6%) were suggestive of injury. These included seven (4.4%) true-positive arteriograms, six (3.8%) false- positive studies, and four (2.5%) positive arteriograms in patients who were not operated upon. The angiographic report correlated with operative findings in five (38.5%) of 13 patients. These data confirm the low incidence (4.4%) of vascular injury in asymptomatic patients. The use of extremity angiography when proximity is the sole indication in an asymptomatic patient with a normal vascular examination must be questioned.

Original languageEnglish (US)
Pages (from-to)512-514
Number of pages3
JournalJournal of Trauma - Injury, Infection and Critical Care
Volume31
Issue number4
DOIs
StatePublished - Apr 1991

ASJC Scopus subject areas

  • Surgery
  • Critical Care and Intensive Care Medicine

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