Clinical Review of Vascular Trauma
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Sixteen of these patients with isolated arterial occlusion on CTA underwent vascular repair.
Muscular branch vessels accounted for the highest incident of arterial extravasation in both upper and lower extremities. Pseudoaneurysms were identified in nearly 14 cases. The superficial femoral artery sustained the highest incidence of pseudoaneurysm on CTA, but this condition was also identified in the brachial, radial, and ulnar arteries.
Clinical Review of Vascular Trauma | Anahita Dua | Springer
Of the nine patients with isolated arterial pseudoaneurysm, only four required vascular repair. Three cases demonstrated arterial dissection, and one case had AV fistula.
Forty-eight patients had extremity CTA exams that were not of diagnostic quality due to suboptimal opacification from poor bolus timing or bolus out run or to vessel effacement by beam hardening artifact. These had a mean attenuation value of HU compared to diagnostic quality exams with mean attenuation values exceeding HU. By reproducing similarly high arterial attenuation HUs , the authors said that their study demonstrated the capability to achieve diagnostic quality images on CTAs of both the upper and lower extremities.
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Although vessel HUs are measured in day-to-day practice, the diagnostic quality of CTA with respect to vessel opacification is often a subjective assessment. In our study, we determined that most diagnostic quality CTA studies demonstrate vessel opacification in the range of HU.
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Colip also said that because DSA remains the gold standard for arterial assessment, and the study assessment time range began in , the researchers were surprised that only eight patients underwent DSA, two of which included endovascular intervention after positive CTAs. One of these patients had endovascular stent placement for a pseudoaneurysm and the other had coil embolization of an intramuscular branch of the deep femoral artery that demonstrated active extravasation on CTA Figure.
Despite the findings of the study, Dr.
Extremity CTA: Rapid, accurate imaging of vascular trauma
Colip said he does not dismiss the use of DSA. He believes it will remain a viable tool in vascular trauma for certain high-risk patients, poor surgical candidates, equivocal or non-diagnostic CTA, and patients with significant metallic artifact. But he and his colleagues do encourage hospitals that are not yet routinely using extremity CTA to assess vascular injury to begin to do so. Extremity CTA: Rapid, accurate imaging of vascular trauma. Appl Radiol. Or filter your current search. Frontiers in Surgery [19 Dec , ].
Abstract Early management of vascular injury, starting at the field, is imperative for survival no less than any operative maneuver.
- Clutter Busting;
Contemporary prehospital management of vascular trauma, including appropriate fluid and volume infusion, tourniquets, and hemostatic agents, has reversed the historically known limb hemorrhage as a leading cause of death. In this context, damage control DC surgery has evolved to DC resuscitation DCR as an overarching concept that draws together preoperative and operative interventions aiming at rapidly reducing bleeding from vascular disruption, optimizing oxygenation, and clinical outcomes.
Outcomes After Anticoagulation for Traumatic Arterial Injuries of the Extremity
This review addresses contemporary DCR techniques from the prehospital to the surgical setting, focusing on civilian vascular injuries. Read Article at publisher's site.
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