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A Prospective Analysis

Fred A. Weaver, MD; Albert E. Yellin, MD; Madeline Bauer, PhD; Jon Oberg, MD; Navid Ghalambor; Richard P. Emmanuel; Robert M. Applebaum, MD; Michael J. Pentecost, MD; Robert M. Shorr, MD

Arch Surg. 1990;125(10):1256-1260.

Abstract
• Three hundred seventy-three patients with a penetrating extremity injury were studied to assess the yield of arteriography. Patients underwent arteriography if any of the following was present: bruit, history of hemorrhage or hypotension, fracture, hematoma, decreased capillary refill, major soft-tissue injury, or nerve or pulse deficit. In the absence of these findings, arteriography was performed if the injury was in "proximity" to a major neurovascular bundle. In 216 patients, arteriography was performed when an abnormal finding was noted. Sixty-five injuries were identified, 19 requiring intervention. Proximity was the indication for arteriography in 157 patients. Seventeen injuries were identified, of which one required repair. In penetrating extremity trauma, the need for arteriography is based on clinical findings. The use of arteriography to screen for an arterial injury when proximity alone is the indication rarely identifies a significant injury and should be abandoned.

(Arch Surg. 1990;125:1256-1260)

Author Affiliations
From the Departments of Surgery (Drs Weaver, Yellin, Bauer, Oberg, Applebaum, and Shorr and Messrs Ghalambor and Emmanuel) and Radiology (Dr Pentecost), University of Southern California School of Medicine, Los Angeles.

Footnotes
Accepted for publication June 9, 1990.

Read before the 61st Annual Meeting of the Pacific Coast Surgical Association, Laguna Niguel, Calif, February 19, 1990.

Reprint requests to Department of Surgery, LAC/USC Medical Center, 1200 N State St, Rm 9442, Los Angeles, CA 90033 (Dr Weaver).

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