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

Victor A. Jebara

Department of Thoracic and Cardiovascular Surgery

Soha N. Haddad

Department of Radiology, Hôtel Dieu de France, St Joseph University Hospital, Beirut, Lebanon

Michel A. Ghossain

Department of Radiology, Hôtel Dieu de France, St Joseph University Hospital, Beirut, Lebanon

Dolly Nehmé

Department of Radiology, Hôtel Dieu de France, St Joseph University Hospital, Beirut, Lebanon

Noël Aoun

Department of Radiology, Hôtel Dieu de France, St Joseph University Hospital, Beirut, Lebanon

Georges Tabet

Department of Thoracic and Cardiovascular Surgery

Ramzi Ashoush

Department of Thoracic and Cardiovascular Surgery

Nagi G. Atallah

Department of Radiology, Hôtel Dieu de France, St Joseph University Hospital, Beirut, Lebanon

Fouad N. Boustany

Department of Radiology, Hôtel Dieu de France, St Joseph University Hospital, Beirut, Lebanon

Bachir Saade

Department of Thoracic and Cardiovascular Surgery

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.

Angiology, Vol. 42, No. 7, 527-532 (1991)
DOI: 10.1177/000331979104200703
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