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Arteriography in Vascular Trauma

- See:
     - Arterial Injuries Assoc. w/ Fractures:
     - Arterial Trauma:
     - Femoral Arteriogram:
     - Upper Extremity Arteriogram of the Limbs 

- Discussion:
    - pts w/ obvious signs of vascular injury, such as rapid external bleeding, an expanding hematoma, signs of distal ischemia, or palpable 
         thrill, are taken to OR for immediate operation;
    - pts w/ suspected injury to a great vessel other than subclavian artery undergo formal arteriography in a radiology suite;
    - all other pts w/ suspected peripheral vascular injuries undergo immediate arteriography by a surgical resident in ER;
- Minor Findings:
    - spasm
    - obstruction of a minor branch vessel
    - arterial displacement by hematoma
- Major Findings:
    - intimal flap or dissection
    - extravasation
    - occlusion
    - pseudoaneurysm
    - acute arteriovenous fistula
- Technical Considerations:
    - r/o renal insufficiency;
    - Femoral Arteriogram:
    - thin walled, 18 gauge, 5.23 cm Cournand disposable needle is inserted either proximal (as in the common femoral artery for superficial
         femoral artery studies) or distal (as in retrograde axillosubclavian artery studies) to the area of suspected injury;
    - depending on artery being evaluated, single rapid hand injection of 25 to 50 ml of 30 % meglumine diatrizoate dye is carried out and a
          single radiograph obtained

Trauma of the extremities: prospective comparison of digital and conventional angiography.

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

Arteriography performed in the emergency center

Can Doppler pressure measurement replace "exclusion" arteriography in the diagnosis of occult extremity arterial trauma?

Non-invasive vascular tests reliably exclude occult arterial trauma in injured extremities.