O'Gorman R B, Feliciano D V
Am J Surg. 1986 Sep;152(3):323-5. doi: 10.1016/0002-9610(86)90267-9.
Arteriography is a sensitive, accurate diagnostic tool for the evaluation of suspected peripheral arterial injuries. A single hand injection study in the emergency center offers a simple, cost-effective, and time-saving maneuver for accomplishing this goal. It is noteworthy that the techniques described are performed with only a minimum of equipment and demand no special training on the part of the radiologic technician. Emergency center arteriography can be beneficial for ruling out suspected peripheral vascular injury in the massively injured patient who will require other extensive procedures. However, the procedure described is probably most beneficial for excluding potential injury in the patient who has no sign of arterial injury other than anatomic proximity of a blunt or penetrating injury to a peripheral vessel. It is true that many surgeons will not order formal arteriograms on an emergency basis for the asymptomatic patient with normal distal pulses, yet we have found that 13 percent of such patients require operative intervention for an arterial injury. It is in precisely this setting that the surgeon can perform a rapid arteriogram in the emergency center. After a negative arteriogram is obtained, the patient can be discharged from the emergency center or admitted for observation with the assurance that arterial injury is absent.
动脉造影术是评估疑似外周动脉损伤的一种灵敏、准确的诊断工具。在急诊中心进行单手注射研究为实现这一目标提供了一种简单、经济高效且节省时间的方法。值得注意的是，所描述的技术仅需最少的设备，且放射技师无需接受特殊培训即可操作。急诊中心动脉造影术有助于排除需要进行其他广泛手术的重症患者的疑似外周血管损伤。然而，所描述的方法可能对排除除钝性或穿透性损伤与外周血管在解剖位置上接近外无动脉损伤迹象的患者的潜在损伤最为有益。诚然，许多外科医生不会在急诊情况下为远端脉搏正常的无症状患者开具正式的动脉造影检查单，但我们发现，此类患者中有13% 需要接受动脉损伤的手术干预。正是在这种情况下，外科医生可以在急诊中心进行快速动脉造影。在获得阴性动脉造影结果后，患者可以从急诊中心出院或入院观察，因为可以确定不存在动脉损伤。
