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An Atypical Presentation of Vascular Injury in Extremity Trauma Beyond Current Guidelines

Taylor Broudy1, Logan Gonsalves2, Jonathan King2

  • 1Department of Surgery, Howard University College of Medicine, Washington, D.C., USA.

Cureus
|September 4, 2025
PubMed

Insights

Computed tomography angiography (CTA) can detect vascular injuries missed by current guidelines. A case study shows CTA identified a femoral arteriovenous fistula in a trauma patient with a normal ankle-brachial index, emphasizing clinical judgment in diagnosis.

Area of Science:

  • Trauma Surgery
  • Vascular Imaging
  • Diagnostic Radiology

Background:

  • Computed tomography angiography (CTA) is crucial for diagnosing vascular injuries in trauma patients.
  • Current Eastern Association for the Surgery of Trauma (EAST) guidelines recommend CTA for abnormal physical findings or ankle-brachial index (ABI) ≤ 0.9.

Keywords:
ankle-brachial indexarteriovenous fistulacomputed tomography angiographyextremity traumavascular injury

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