Penetrating arterial trauma. Analysis of missed vascular injuries
J. D. Richardson, G. C. Vitale and L. M. Flint Jr
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.
