Tuesday, November 6, 2012

Lower Extremity Arterial Trauma

A middle aged male presented with a femur fracture sustained after a tree fell on his leg. After closed reduction of the fracture, peripheral pulses were absent. Diagnostic conventional angiogram demonstrated a dissection of the distal superficial femoral artery at the level of the fracture with no distal reconstitution of the popliteal artery.

Imaging recommendations:
  • perform CT angiography in patients who are stable and have suspected (but not confirmed) arterial injury
    • faster than conventional angiography
    • limitations include poor timing of contrast bolus, streak and motion artifact
  • conventional angiography in patients with strong indication of arterial injury
    • prolongs ischemic time 
    • radiologic intervention is possible and preferred over surgical exploration.

Miller-Thomas MM, West OC, Cohen AM. Diagnosing traumatic arterial injury in the extremities with CT angiography: pearls and pitfalls. Radiographics 2005;25:S133-42.
Rieger M, Mallouhi A, Tauscher T, et al. Traumatic arterial injuries of the extremities: initial evaluation with MDCT angiography. AJR Am J Roentgenol 2006;186(3):656-64.

No comments:

Post a Comment

Note: Only a member of this blog may post a comment.