Multi-Detector Computed Tomography Angiographic Evaluation of Extremity Vascular Trauma: Case Series

Krishna Kumar M. *

Department of Radio-Diagnosis, Trichy SRM Medical College Hospital and Research Centre, Irungalur, Trichy-621105, India.

Anil Kumar V.

Trichy SRM Medical College Hospital and Research Centre, Irungalur, Trichy-621105, India.

Arun R.

Department of Radio-Diagnosis, Trichy SRM Medical College Hospital and Research Centre, Irungalur, Trichy-621105, India.

Senthilnathan V.

Department of Radio-Diagnosis, Trichy SRM Medical College Hospital and Research Centre, Irungalur, Trichy-621105, India.

*Author to whom correspondence should be addressed.


Abstract

Objective: The purpose of this article is to review the multidetector computed tomography (MDCT) angiography within the evaluation of extremity trauma. Trauma could be a great public health dilemma in developing and developed countries and regularly involves teenagers. Among different kinds of trauma, vascular injuries of the extremities need special consideration because they’ll be threatening to limb and life. Vascular injury going to exsanguination and hemorrhagic shock is second to central nervous system injury; thus, imaging diagnosis is crucial for the trauma victim as early as possible from admission to the hospital. Although the speed of successful management of those injuries has been increased because of proper pre hospitalization, early referral of patients to specialized trauma centers, and proper surgical interventions, these injuries remain a challenging problem, especially in developing countries.

Conclusion: With the rising trend of road traffic accidents and violence, vascular injuries have become a significant contributor of limb loss, with increased morbidity and mortality. MDCT Angiography has become the most non-invasive diagnostic imaging vascular triage tool applicable to all or any varieties of extremity trauma. Axial sections, multiplanar reconstructions and 3D volume-rendered images should aid within the detection and improve the interpretation of such vascular injuries, osseous and soft-tissue injuries which could be of immense help to the clinician planning surgical procedures.  

Keywords: Computed tomography angiography, extremity trauma, extremity vascular trauma, multi-detector computed tomography angiography


How to Cite

M. , K. K., V. , A. K., R. , A., & V. , S. (2023). Multi-Detector Computed Tomography Angiographic Evaluation of Extremity Vascular Trauma: Case Series. Asian Journal of Research in Medical and Pharmaceutical Sciences, 12(4), 27–37. https://doi.org/10.9734/ajrimps/2023/v12i4229

Downloads

Download data is not yet available.

References

Marx J. Rosen’s emergency medicine: Concepts and clinical practice. 7th ed. Philadelphia, PA: Mosby/Elsevier; 2010.

Nikhil Madhuripan, Parthiv Mehta, Sara E. Smolinski, Njogu Njuguna, Computed tomography angiography of the extremities in emergencies, seminars in ultrasound, CT and MRI. 2017;38(4):357-369. ISSN 0887-2171.

Available:https://doi.org/10.1053/j.sult.2017.03.001

Engel A, Soudeck M, Ofer A, et al.Coping with war mass casualties in a hospital under fire: The radiology experience. AJR Am J Roentgenol. 2009;193:1212-1221.

Fishman EK. Spiral CT: Applications in the emergency patient. Radiographics. 1996; 16:943- 948.

Eli Atar. Vascular imaging in the setting of trauma. Endovascular Today. 2011;25-28.

Compton C, Rhee R. Peripheral vascular trauma. Perspect Vasc Surg Endovasc Ther. 2005; 17:297– 307.

Mandip S, Gakhal, Kamyar A. Sartip. CT Angiography signs of lower extremity vascular trauma. AJR. 2009;193:W49–W57.

Miller-Thomas MM, West OC, Cohen AM. Diagnosing traumatic arterial injury in the extremities with CT angiography: Pearls and pitfalls. RadioGraphics 2005;25:S133–S142.

Foster BR, Anderson SW, Soto JA. CT angiography of extremity trauma. Tech Vasc Interv Radiol. 2006;9:156–166.

Fishman EK, Horton KM, Johnson PT. Multidetector CT and three-dimensional CT angiography for suspected vascular trauma of the extremities. RadioGraphics 2008;28:653–665.

Saad NEA, Saad WEA, Davies MG, Waldman DL, Fultz PJ, Rubens DJ. Pseudoaneurysms and the role of minimally invasive techniques in their management. RadioGraphics 2005; 25:S173– S189.

Rieger M, Mallouhi A, Tauscher T, Lutz M, Jaschke W. Traumatic arterial injuries of the extremities: Initial evaluation with MDCT angiography. AJR. 2006;186:656–664.

Soto JA, Múnera F, Morales C, et al. Focal arterial injuries of the proximal extremities: Helical CT arteriography as the initial method of diagnosis. Radiology. 2001;218:188–194.

Kauvar DS, Sarfati MR, Kraiss LW. National trauma databank analysis of mortality and limb loss in isolated lower extremity vascular trauma. J Vasc Surg. 2011; 53(6):1598–603.

Frykberg ER. Popliteal vascular injuries. Surg Clin N Am. 2002;82(1):67–89.

Franz RW, Skytta CK, Shah KJ, Hartman JF, Wright ML. A fiveyear review of management of upper-extremity arterial injuries at an urban level I trauma center. Ann Vasc Surg. 2012;26(5):655–64.

Hellinger JC, Epelman M, Rubin GD. Upper extremity computed tomographic angiography: state of the art technique and applications in 2010. Radiol Clin North Am. 2010;48:397–421.

Adoriasio RVE, Sgarbi G. Arterial injury of the axilla, an unusual case after blunt trauma of the shoulder. J Trauma. 1996;41:754–6

Sparks SR, DeLaRosa J, Bergan JJ, Hoyt DB, Owens EL. Arterial injury in uncomplicated upper extremity dislocations. Ann Vasc Surg. 2000;14(2):110–3.

Zaiton Fatma, Ahmed Ayman F, Samir Ayman M. Value of multislice computed tomography angiography (MCTA) in neglected post traumatic vascular injuries of the extremities. Egypt J Radiol Nucl Med 2013;44:539–46.

:539–46.

Bhalla D, Kumar A, Gamanagatti S. et al. Imaging in extremity vascular trauma: Can MDCT angiography predict the nature of injury? Emerg Radiol 2022;29:683–690. Available:https://doi.org/10.1007/s10140-022-02050-4

Sean P Kelly, MC, USA and others, The Role of CT Angiography in evaluating lower extremity trauma: 157 Patient Case Series at a Military Treatment Facility, Military Medicine. 2019;184(9-10):e490–e493.

Available:https://doi.org/10.1093/milmed/usz028

Brian R, Bennett DJ, Kim WC, et al Computed tomography angiography is associated with low added utility for detecting clinically relevant vascular injuries among patients with extremity trauma. Trauma Surgery & Acute Care Open. 2021;6:e000828. DOI: 10.1136/tsaco-2021-000828