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Angiographic yield in penetrating extremity trauma
V Henderson1, R Nambisan, M E Smith
1Department of Surgery, University of California, Davis-East Bay, Oakland 94602.
The Western Journal of Medicine
|September 11, 1991
Summary
Angiography is valuable for penetrating extremity trauma with abnormal findings or gunshot wounds near major vessels. However, it is not recommended for stab wounds or isolated neurologic deficits, which poorly predict vascular injury.
Area of Science:
- Vascular Surgery
- Trauma Surgery
- Diagnostic Imaging
Background:
- Indications for angiography in penetrating extremity trauma are debated.
- Clinical findings and angiographic results require correlation.
Purpose of the Study:
- To determine the diagnostic yield of angiography in penetrating extremity trauma.
- To correlate clinical indicators with angiographic outcomes.
Main Methods:
- Retrospective review of 284 extremity arteriograms in 268 patients over 81 months (1983-1989).
- Analysis of angiographic yield based on clinical findings and injury characteristics.
Main Results:
- Overall angiographic yield was 51% for patients with abnormal clinical findings.
- Yield was 6% for proximity injuries (7% gunshot, 0% stab wounds) as the sole indication.
- Isolated neurologic deficits yielded negative angiograms in 55% and no positive findings.
Conclusions:
- Continue angiography for extremity gunshot wounds with proximity to major vessels.
- Discontinue angiography for extremity stab wounds where proximity is the sole indication.
- Isolated neurologic deficits are poor predictors of vascular injury and do not warrant angiography.