Arteriography performed in the emergency center.

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.