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January 1983

Evaluation and Management of Vascular Injuries of the Extremities

Author Affiliations

From the Departments of Surgery (Drs Menzoian, Doyle, LoGerfo, and Ms Cantelmo) and Radiology (Drs Weitzman and Sequiera), Boston University School of Medicine.

Arch Surg. 1983;118(1):93-95. doi:10.1001/archsurg.1983.01390010069016

• We reviewed our experience with 315 extremity injuries in 306 patients for the possibility of accurately evaluating the presence of a potential vascular injury. Indications for surgical exploration based on the clinical finding of a bruit and/or thrill, ischemia, absent pulse, shock, hemorrhage, neurologic deficit, hematoma, and proximity resulted in a rate of positive surgical exploration results of between 20% and 100%. Anglography was performed in 65 patients; 24 angiograms showed vascular injury and 41 did not. Angiography for proximity alone revealed 12% abnormal finding. Operative morbidity in the surgically explored group was 2%. We developed an algorithm for the treatment of these patients.

(Arch Surg 1983;118:93-95)