Vascular trauma to the extremities and lower neck: initial assessment with intravenous digital subtraction...

Rapid assessment of a patient with possible major peripheral vascular injury is essential to preserve limb function. Intravenous digital subtraction angiography (IV DSA) allows rapid evaluation of these patients without the need for intraarterial examination. We report our experience in 295 vessels studied by IV DSA for the evaluation of possible traumatic arterial injury to the extremities or neck. Of our study population requiring angiography (469 patients), 63.4% were appropriate candidates for IV DSA. Of the vessels studied by IV DSA, 93.6% required no further radiologic evaluation. A normal appearance on IV DSA study indicates no major vascular injury; patients with positive studies may proceed to surgery without further interventional assessment.