Drake Aaran, Dreyer Nicholas, Hoffer Megan, Boniface Keith
The George Washington University School of Medicine and Health Sciences, Department of Emergency Medicine, Washington, DC.
Clin Pract Cases Emerg Med. 2022 Feb;6(1):1-7. doi: 10.5811/cpcem.2021.11.54904.
The use of point-of care ultrasound (POCUS) in the evaluation of vascular emergencies including abdominal aortic aneurysm and deep vein thrombosis is well established. However, no current guidelines exist to outline the use of POCUS in the management of acute peripheral arterial pathology.
Here, we present a case series that illustrates the utility of POCUS in the assessment of both traumatic and nontraumatic peripheral arterial disease. Direct visualization of the vasculature via B-mode, color Doppler, and pulsed-wave Doppler assisted in the diagnosis of the following: 1) an acute, post-catheterization thrombus of the proximal radial artery; 2) a complete, traumatic radial artery transection; 3) a forearm hematoma with active arterial extravasation; 4) a traumatic arteriovenous fistula; 5) an acute thrombosis of an artery bypass graft; and 6) an infected pseudoaneurysm.
The incorporation of POCUS into patient care allowed for rapid identification of significant peripheral arterial pathology and led to changes in clinical management, expedited patient care, and circumvented potentially harmful complications.
即时超声（POCUS）在评估包括腹主动脉瘤和深静脉血栓形成在内的血管急症中的应用已得到充分确立。然而，目前尚无指南概述POCUS在急性外周动脉疾病管理中的应用。
在此，我们展示了一个病例系列，阐述了POCUS在评估创伤性和非创伤性外周动脉疾病中的效用。通过B超、彩色多普勒和脉冲波多普勒对血管系统进行直接可视化，有助于诊断以下情况：1）桡动脉近端导管插入术后急性血栓形成；2）桡动脉完全性创伤性横断；3）伴有动脉活动性外渗的前臂血肿；4）创伤性动静脉瘘；5）动脉搭桥移植物急性血栓形成；6）感染性假性动脉瘤。
将POCUS纳入患者护理可快速识别严重的外周动脉疾病，并导致临床管理的改变、加快患者护理并避免潜在的有害并发症。
