Emergency center arteriography in the evaluation of suspected peripheral vascular injuries in children.
During the 6-year period from 1983 to 1989, 109 children aged 3 to 18 years (mean, 16) with suspected peripheral vascular injuries underwent 113 emergency center arteriograms (ECA) performed by hand injection of contrast material using a single roentgenographic film. The most common indication for ECA was the proximity of the injury in 93 (82.3%) of the cases as penetrating injury accounted for 106 (94%) of the cases. There were 89 true-negative, 14 true-positive, 1 false-negative, and no false-positive arteriograms. The remaining 9 arteriograms were either equivocal or technically inadequate. The sensitivity, specificity, and diagnostic accuracy of this procedure were 98.9%, 100%, and 91.2%, respectively. Operative intervention was required for 9 (64.2%) injuries detected by emergency arteriography. The remaining 5 injuries were considered minor and were observed with no complications during a period of 21 months. Sixty-eight children (76.4%) with negative ECA were followed for a mean of 12 months with no vascular complications or growth abnormalities noted. ECA is a rapid, accurate, and cost-effective technique. It is of particular value in detecting the presence of occult arterial injuries that might have deleterious effects in the growing child.
Itani
K M
KM
Cora and Webb Madding Department of Surgery, Baylor College of Medicine, Houston, TX.
Rothenberg
S S
SS
Brandt
M L
ML
Burch
J M
JM
Mattox
K L
KL
Harberg
F J
FJ
Pokorny
W J
WJ
D000293:Adolescent; D000792:Angiography; D001158:Arteries / Q000293:injuries*; D002648:Child; D002675:Child, Preschool; D003974:Diatrizoate Meglumine; D004632:Emergency Medical Services; D005121:Extremities / Q000098:blood supply* / Q000293:injuries*; D005260:Female; D006801:Humans; D008297:Male; D012680:Sensitivity and Specificity; D014947:Wounds and Injuries / Q000000981:diagnostic imaging / Q000209:etiology
D003974:Diatrizoate Meglumine