Remote arterial injury. Another cause of spurious arterial spasm

The need for urgent diagnosis and treatment of arterial injury is fully accepted but surgical exposure of the injured vessel is often preferred to pre-operative diagnosis by arteriography. Exposure of the artery at the site of limb injury may reveal spasm or thrombosis without evidence of direct trauma to the vessel. In that case, traction injury of the artery remote from the surgical field is likely. Commonly this affects a proximal segment of the artery but it can occur at a distal fixed point also. Attempts at thrombectomy risk further disruption of the vessel and diagnostic arteriography is required for satisfactory management. An illustrative case is presented.