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April 1978

The Validity of Normal Arteriography in Penetrating Trauma

Author Affiliations

From the Department of Surgery (Dr Snyder, Thai, Bridges, and Fry), Southwestern Medical School, the University of Texas Health Science Center, Dallas, the Department of Radiology (Dr Gerlock) Vanderbilt University Hospital, Nashville, Tenn, and the Department of Surgery (Dr Perry), the University of Washington Health Science Center, Seattle.

Arch Surg. 1978;113(4):424-428. doi:10.1001/archsurg.1978.01370160082013

• The detection of underlying arterial injury is a major problem in the management of penetrating trauma. Arteriovenous fistula and false aneurysm are late sequelae of unrepaired injuries. The diagnostic accuracy of arteriography in clinically occult injury has not been defined.

One hundred and seventy-seven patients with 183 penetrating extremity wounds underwent arteriography followed by operative vessel exploration. Arteriogram/operation correlation demonstrated 36 true-positive, 132 true-negative, 14 false-positive, and one false-negative arteriogram.

Arteriography is sufficiently sensitive to exclude the presence of arterial injury in patients with equivocal clinical signs of injury. The radiographic changes are often subtle and diagnostic accuracy demands attention to the details of technique and interpretation. Unequivocal clinical signs of arterial injury and any arteriographic abnormality are indications for operative exploration.

(Arch Surg 113:424-428, 1978)

Perry MO, Thal ER, Shires GT:  Management of arterial injuries . Ann Surg 173:403-408, 1971.Article
Drapanas T, Hewett RL, Weichert RF, et al:  Civilian vascular injuries: A critical appraisal of three decades of management . Ann Surg 172:351-360, 1970.Article
Flint LM, Snyder WH III, Perry MO, et al:  Management of major vascular injuries in the base of the neck: An 11-Year experience with 146 cases . Arch Surg 106:407-413, 1973.Article
Lumpkin MB, Logan WD, Couves CM, et al:  Arteriography as an aid in the diagnosis and localization of acute arterial injuries . Ann Surg 147:353-358, 1958.Article
McDonald EJ Jr, Goodman PC, Winestock DP:  The clinical indications for arteriography in trauma to the extremity: A review of 114 cases . Radiology 116:45-47, 1975.Article
Smith RF, Elliott JP, Hageman JH, et al:  Acute penetrating arterial injuries of the neck and limbs . Arch Surg 109:198-205, 1974.Article
Sinkler WH, Spencer AD:  The value of peripheral arteriography in assessing acute vascular injuries . Arch Surg 80:300-304, 1960.Article
Patman RD, Poulos E, Shires GT:  The management of civilian arterial injuries . Surg Gynecol Obstet 118:725-738, 1964.
Bole PV, Munda R, Purdy RT, et al:  Traumatic pseudoaneurysms: A review of 32 cases . J Trauma 16:63-70, 1976.Article
Fomon JJ, Warren WD:  Late complications of peripheral arterial injuries . Arch Surg 91:610-616, 1965.Article
Rich NM, Hobson RW II, Collins GJ Jr:  Traumatic arteriovenous fistulas and false aneurysms: A review of 558 lesions . Surgery 78:817-828, 1975.
Lindenauer SM, Thompson NW, Kraft RO, et al:  Late complications of traumatic arteriovenous fistulas . Surg Gynecol Obstet 129:525-532, 1969.
Rich NM, Hughes CW, Baugh JH:  Management of venous injuries . Ann Surg 171:724-730, 1970.Article
Rich NM, Collins GJ Jr, Anderson CA, et al:  Autogenous venous interposition grafts in repair of major venous injuries . J Trauma 17:512-520, 1977.Article
Gerlock AJ JR, Thal ER, Snyder WH III:  Venography in penetrating injuries of the extremities . Am J Roentgenol Radium Ther Nucl Med 126:1023-1027, 1976.Article
Lain KC, Williams GR:  Arteriography in acute peripheral arterial injuries: An experimental study . Surg Forum 21:179-181, 1970.
Saletta JD, Freeark RJ:  The partially severed artery . Arch Surg 97:198-205, 1968.Article