A comprehensive approach to extremity vascular trauma
J. O. Menzoian, J. E. Doyle, N. L. Cantelmo, F. W. LoGerfo and E. Hirsch
A review of our experience with 368 patients with 382 extremity injuries
has resulted in a treatment plan resulting in improved patient care and
limb survival. A thorough examination of the injured extremity will help
diagnose a significant vascular injury in the presence of certain clinical
findings, eg, bruit or thrill (100%), signs of acute ischemia (100%),
absent pulse (91%), shock (89%), neurologic deficit (78%), and hematoma
(55%). Arteriography in proximity injuries has resulted in an abnormal
finding in 16% of cases. A total of 165 vascular injuries, including 112
arterial and 53 venous injuries, were repaired using a variety of
techniques. In 136 patients undergoing operative intervention, there was no
operative mortality and a 1.5% amputation rate.
