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November 28, 1977

Evaluation of Trauma With Angiograph-Reply

JAMA. 1977;238(22):2366. doi:10.1001/jama.1977.03280230030008

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Dr Gaspar's comments about the hazards accompanying a diagnosis of arterial spasm are true. From the angiographic point of view, however, spasm is a tenable diagnosis. In both of the cases that are illustrated, peripheral pulses were present and arterial injury was not seriously considered clinically, although in the case illustrated in my Fig 1, it was felt advisable to rule out any major injury. Dr Gaspar and I differ in that I feel that intimal destruction presents a very different angiographic picture from the slight smooth narrowings that are illustrated in my Fig 1 and 2. An intimal flap is frequently seen, and there may be a short section of dissection. Contusion presents a much more irregular arterial narrowing.