Emergency Arteriography in the Assessment of Penetrating Trauma to the Lower Limbs

• Published in: Angiology 1991-07, Vol.42 (7), p.527-532
• Main Authors: Jebara, Victor A., Haddad, Soha N., Ghossain, Michel A., Nehmé, Dolly, Aoun, Noël, Tabet, Georges, Ashoush, Ramzi, Atallah, Nagi G., Boustany, Fouad N., Saade, Bachir
• Format: Article
• Language: English
• Subjects: Adult; Angiography; Biological and medical sciences; Emergency Medical Services; Female; Femoral Artery - injuries; Humans; Leg Injuries - diagnostic imaging; Male; Medical sciences; Popliteal Artery - injuries; Predictive Value of Tests; Sensitivity and Specificity; Traumas. Diseases due to physical agents; Vascular injuries: limbs, aorta, vena cava; Wounds, Gunshot - diagnostic imaging
• ISSN: 0003-3197; 1940-1574
• DOI: 10.1177/000331979104200703

One hundred emergency arteriographies (EA) were performed in 87 patients with lower limb trauma due to high-velocity missiles. Thirteen patients had bilateral injuries. In 79 cases, EA findings were positive and led to emergency surgery. In 76 cases an arterial injury was found and treated, a positive predic tive value of 96% (76/79). In the other 3 cases, no arterial lesion was found (3 false positives). Among the 21 patients with normal findings from angiography, 10 had surgical exploration because of high clinical suspicion of vascular injury. Arterial injury was found in 2 cases (2 false negatives). In 8 patients, arteriogra phy modified the surgical procedure. In the 11 remaining patients, clinical and echo Doppler follow-up results were normal, a negative predictive value of 90% (19/21). Sensitivity was 97%, specificity 86%, and accuracy 95%. These data show that arteriography in stable patients is a safe and accurate procedure. It permits avoidance of unnecessary surgical exploration in selected patients and helps modify the surgical procedure.