title: Extremity CTA for penetrating trauma: 10-year experience using a 64-detector row CT scanner.
abstract: OBJECTIVE
  The purpose of this study is to assess the performance of CT angiography (CTA) in the evaluation of penetrating vascular trauma to the extremities in a large cohort of patients at our level I trauma center.
  
  
  METHODS
  A retrospective, IRB-approved review of consecutive CTAs for the evaluation of penetrating trauma to the extremities in 446 patients (M/F = 396:50, mean age = 27 years) from 1/1/2005 to 5/1/2015 was performed. Medical records were reviewed to correlate diagnostic imaging findings with clinical history and subsequent interventions. Image quality was quantified by measurement of CT attenuation coefficients in the major arteries of the extremities. The Fisher's exact test was used to analyze the relationships between the presence and type of vascular injury and subsequent clinical management.
  
  
  RESULTS
  One hundred and thirty-one (29.4 %) of 446 patients with penetrating trauma demonstrated major vascular injury on CTA, 35 (26.7 %) of whom underwent subsequent surgical repair. None of the patients without vascular injury on CTA underwent subsequent vascular intervention. Fisher's exact test demonstrated a statistically significant difference in management and requirement for vascular repair in those patients with a vascular injury on CTA when compared to those without a vascular injury (p < 0.0001). The mean attenuation values achieved in upper and lower extremity CTAs in this population exceeded 250 HU.
  
  
  CONCLUSIONS
  Extremity CTA is found to be an accurate tool for surgical triage in patients having sustained penetrating vascular trauma.
authors.affiliation: Boston University Medical Center, 840 Harrison Ave, Boston, MA, 02118, USA. charles.colip@bmc.org.|, 11 W Broadway St Unit 310, Boston, MA, 02127, USA. charles.colip@bmc.org.
authors.forename: Charles G
authors.initials: CG
authors.lastname: Colip
authors.affiliation: Boston University Medical Center, 840 Harrison Ave, Boston, MA, 02118, USA.
authors.forename: Varun
authors.initials: V
authors.lastname: Gorantla
authors.affiliation: Boston University Medical Center, 840 Harrison Ave, Boston, MA, 02118, USA.
authors.forename: Christina A
authors.initials: CA
authors.lastname: LeBedis
authors.affiliation: Boston University Medical Center, 840 Harrison Ave, Boston, MA, 02118, USA.
authors.forename: Jorge A
authors.initials: JA
authors.lastname: Soto
authors.affiliation: Boston University Medical Center, 840 Harrison Ave, Boston, MA, 02118, USA.
authors.forename: Stephan W
authors.initials: SW
authors.lastname: Anderson
mesh_terms: D000328:Adult; D000072226:Computed Tomography Angiography / Q000295:instrumentation*; D005121:Extremities / Q000000981:diagnostic imaging* / Q000293:injuries*; D005260:Female; D006801:Humans; D008297:Male; D009104:Multiple Trauma; D012189:Retrospective Studies; D014193:Trauma Centers; D057772:Vascular System Injuries / Q000000981:diagnostic imaging*; D014950:Wounds, Penetrating / Q000000981:diagnostic imaging*
keywords: CTA; Extremity; Penetrating; Trauma