Traumatic arterial injuries in upper and lower limbs: what every radiologist should know

Zhou, Zhao Hui Chen; Chamorro, E. Martínez; Sanz, L. Ibáñez; Lucas, Raquel Sanz De; Fernández, M. Chico; Nacenta, S. Borruel

doi:10.1007/s10140-022-02053-1

Cited by 1 publication

(2 citation statements)

References 11 publications

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“…CTA evidence of vascular injury included active bleeding, occlusion, vasospasm, pseudoaneurysm, post-traumatic arteriovenous fistula and intimal injuries. 9 Data analysis was performed using SPSS (v24; IBM, Armonk, NY, USA). Univariate analysis was performed with independent sample t-tests for continuous data (age) and Fisher's exact test for categorical data (gender, blunt vs. penetrating mechanism, high-vs. low-energy trauma, affected limb, knee dislocation, hard signs, soft signs, API).…”

Section: Methodsmentioning

confidence: 99%

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Indications for computed tomography angiography in limb trauma

Awal,

De Groot

2023

J Med Imag Rad Onc

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IntroductionComputed tomography angiograms (CTAs) are useful in detecting vascular injury. There is a lack of consensus regarding the indications of CTAs in limb trauma, leading to overutilisation of CTAs in some centres and exposing patients to unnecessary harm. Thus, the aim of this study is to define the appropriate indications for CTAs in limb trauma.MethodsThis is a retrospective cohort study of consecutive CTAs performed in a tertiary hospital from January to December 2022. Demographic and clinical factors were collected from the patients' charts including physical examination findings and arterial pressure index (API) measurements. Physical examination findings include hard signs (e.g. absent pulse) or soft signs (e.g. non‐expanding haematoma). These data were analysed to detect correlation with vascular injury on the patient's CTA.ResultsForty‐nine CTAs were included, of which 10 (20.4%) found vascular injury. Hard signs (P < 0.001) and an API <0.9 (P = 0.02) were significantly correlated with vascular injury. Hard signs had a sensitivity of 90% and specificity of 82%, whereas APIs had a specificity and sensitivity of 100%. Soft signs were not correlated with vascular injury due to poor specificity but had a sensitivity of 100%. Knee dislocations were not associated with vascular injury (P = 0.5).ConclusionThis small study suggests that CTAs are indicated if there are hard signs of vascular compromise or an API <0.9, provided the patient is haemodynamically stable. The presence of soft signs can help identify which patients should receive an API measurement. CTAs may not be routinely indicated in knee dislocations.

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Section: Methodsmentioning

confidence: 99%

“…Knee dislocations were defined as anterior or posterior tibiofemoral joint dislocations and did not include patellofemoral joint dislocations. CTA evidence of vascular injury included active bleeding, occlusion, vasospasm, pseudoaneurysm, post‐traumatic arteriovenous fistula and intimal injuries 9 …”

Section: Methodsmentioning

confidence: 99%

Indications for computed tomography angiography in limb trauma

Awal,

De Groot

2023

J Med Imag Rad Onc

View full text Add to dashboard Cite

show abstract

Traumatic arterial injuries in upper and lower limbs: what every radiologist should know

Cited by 1 publication

References 11 publications

Indications for computed tomography angiography in limb trauma

Indications for computed tomography angiography in limb trauma

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