Evaluation and management of vascular injuries of the extremities.
We reviewed our experience with 315 extremity injuries in 306 patients for the possibility of accurately evaluating the presence of a potential vascular injury. Indications for surgical exploration based on the clinical finding of a bruit and/or thrill, ischemia, absent, pulse, shock, hemorrhage, neurologic deficit, hematoma, and proximity resulted in a rate of positive surgical exploration results of between 20% and 100%. Angiography was performed in 65 patients; 24 angiograms showed vascular injury and 41 did not. Angiography for proximity alone revealed 12% abnormal finding. Operative morbidity in the surgically explored group was 2%. We developed an algorithm for the treatment of these patients.
D000293:Adolescent; D000328:Adult; D000792:Angiography; D001808:Blood Vessels / Q000293:injuries*; D002648:Child; D002675:Child, Preschool; D005121:Extremities / Q000098:blood supply*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014656:Vascular Surgical Procedures