Evaluation and management of vascular injuries of the extremities
J. O. Menzoian, J. E. Doyle, F. W. LoGerfo, N. Cantelmo, A. F. Weitzman and J. C. Sequiera
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.
