Hemorrhage is the sine quo non of vascular trauma. Extremity bleeding is often obvious, while bleeding in the chest or abdomen is identified at operation. When the diagnosis is not obvious, imaging is needed to evaluate severity and extent and to facilitate operative planning whether it is open operation or endovascular therapy. Imaging options depend on clinical circumstances, mechanism of injury, and available resources. Transcatheter angiography has a role, especially when endovascular therapy is to be considered. Noninvasive modalities, such as Doppler pressure measurements and duplex ultrasound (US), screen for vascular injury or assess completed repairs, whereas computed tomography angiography (CTA) is the workhorse due to its availability and effectiveness. Triage of patients with extremity vascular injury is possible with physical examination and with measurement of the injured extremity index (IEI). However, CTA is the study of choice for extremity vascular injury and for those injuries in the torso or cervical regions.1,2 Finally, surgeons should have knowledge to employ ultrasound and angiographic techniques to allow the diagnosis vascular injury or the assessment of a vascular repair.
|Original language||English (US)|
|Title of host publication||Rich's Vascular Trauma|
|Number of pages||12|
|State||Published - Jan 1 2015|
ASJC Scopus subject areas