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Diagnosis of Vascular Trauma

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Clinical Review of Vascular Trauma

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Abstract

Improved access, greater speed of acquisition, and higher quality of various imaging modalities in conjunction with possible endovascular options for therapy have changed the initial management of patients with vascular trauma. Basic chest radiography is a sensitive indicator for blunt aortic injury, while a focused assessment with sonography in trauma (FAST) ultrasound study can be used to noninvasively diagnose intra-abdominal hemorrhage and hemopericardium. Duplex ultrasonography can evaluate peripheral vessels with a high sensitivity and specificity for vascular injury. A 64-slice computed tomogram can be completed in the trauma bay as soon as the primary and secondary surveys are done; when combined with IV contrast dye, a high-quality evaluation of both vascular and soft tissue injuries can be completed. Adjuncts such as magnetic resonance angiography may be helpful in diagnosing specific types of injury. In many cases, trauma patients with vascular injuries may be candidates for diagnosis of their injuries using catheter angiography. Advances in endovascular surgery may permit the use of stents, coils, and grafts to repair the affected vessel using nothing more than a groin puncture. These imaging studies can be used for preoperative planning and appropriate prioritization of a patient’s general trauma, orthopedic, neurosurgical, and vascular injuries.

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Authors and Affiliations

  1. Department of Surgery, Albany Vascular Group, Albany Medical College, Albany, NY, USA

    John Byrne MCh, FRCSI (Gen) & R. Clement Darling III MD

  2. Division of Vascular Surgery, Albany Medical Center Hospital, Albany, NY, 12208, USA

    John Byrne MCh, FRCSI (Gen) & R. Clement Darling III MD

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  1. John Byrne MCh, FRCSI (Gen)
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  2. R. Clement Darling III MD
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Correspondence to R. Clement Darling III MD .

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Editors and Affiliations

  1. Department of Surgery MSB 5.030, Center for Translational Injury Research, Houston, Texas, USA

    Anahita Dua

  2. Department of Surgery, University of Texas-Houston Duke University School of Medicine, Houston, Texas, USA

    Sapan S. Desai

  3. Department of Surgery, University of Texas-Houston, Houston, Texas, USA

    John B. Holcomb

  4. Department of Orthopedics, University of Texas-Houston, Houston, Texas, USA

    Andrew R. Burgess

  5. Department of Surgery, John Hopkins Medical Institutions, Baltimore, Maryland, USA

    Julie Ann Freischlag

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Byrne, J., Darling, R.C. (2014). Diagnosis of Vascular Trauma. In: Dua, A., Desai, S., Holcomb, J., Burgess, A., Freischlag, J. (eds) Clinical Review of Vascular Trauma. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-39100-2_3

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