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Analysis of Missed Vascular Injuries

J. David Richardson, MD; Gary C. Vitale, MD; Lewis M. Flint, Jr, MD

Arch Surg. 1987;122(6):678-683.

Abstract
• From 1976 to 1981, 677 patients with potential vascular injuries from penetrating wounds to the upper and lower extremities and the neck were treated. Surgical exploration was used to evaluate 237 patients; 440 patients were evaluated by arteriography alone, with negative results. In the group that underwent surgery, there were 137 arterial injuries detected. Follow-up studies were performed to assess the rate of missed vascular injuries using each diagnostic modality. Short-term follow-up was obtained in 81% of all patients. Long-term follow-up, averaging 5.1 years, was obtained in 33% of the patients. Vascular injuries, which went undetected at the time of initial evaluation, were present in both the group evaluated by vascular exploration and the arteriography group. The combination of arteriography and exploration detected no missed injuries on follow-up.

(Arch Surg 1987;122:678-683)

Author Affiliations
From the Departments of Surgery, University of Louisville School of Medicine (Drs Richardson and Vitale); and State University of New York at Buffalo (Dr Flint).

Footnotes
Accepted for publication Jan 12, 1987.

Read before the 94th Annual Meeting of the Western Surgical Association, Dearborn, Mich, Nov 19, 1986.

Reprint requests to the Department of Surgery, University of Louisville, Louisville, KY 40292 (Dr Richardson).

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