Document Detail


Emergency center arteriography.
MedLine Citation:
PMID:  1548718     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
From 1983 through 1989, 1,882 emergency center arteriograms were performed on 1,802 patients suspected of having peripheral vascular injuries. The most common indication for emergency center arteriography (ECA) was the proximity of an injury to a major vascular structure. This was the only indication in 1,712 injured extremities (91%). There were 1,510 true negative arteriograms, 294 true positives, 7 false negatives, and 14 false positives. Accordingly, the sensitivity was 95.5% and the specificity was 97.7%. The remaining 57 arteriograms were either equivocal or technically inadequate. Further evaluation of these patients uncovered an additional 11 vascular injuries. Operative intervention was required for 196 (64.3%) injuries detected by emergency arteriography. The remaining 109 injuries were considered minor and were not repaired. No complications developed in 91 patients (88%) with minor vascular injuries who were available for a mean follow-up duration of 12 months. One thousand forty-eight patients (69.4%) with negative arteriograms were followed for a mean of 18 months, and no vascular complications were noted. Emergency center arteriography is a rapid, accurate, and cost-effective technique. It is of particular value in detecting the presence of occult arterial injuries when proximity of a major vascular structure is the sole indication for arteriography. When formal arteriographic support is either unavailable or time consuming, ECA is recommended.
Authors:
K M Itani; J M Burch; V Spjut-Patrinely; R Richardson; R R Martin; K L Mattox
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of trauma     Volume:  32     ISSN:  0022-5282     ISO Abbreviation:  J Trauma     Publication Date:  1992 Mar 
Date Detail:
Created Date:  1992-04-23     Completed Date:  1992-04-23     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0376373     Medline TA:  J Trauma     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  302-6; discussion 306-7     Citation Subset:  AIM; IM    
Affiliation:
Cora and Webb Mading Department of Surgery, Baylor College of Medicine, Houston, TX 77030.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Angiography* / economics
Blood Vessels / injuries*
Child
Child, Preschool
Cost-Benefit Analysis
Emergency Service, Hospital*
False Negative Reactions
False Positive Reactions
Female
Humans
Male
Middle Aged
Sensitivity and Specificity
Vascular Surgical Procedures / methods

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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