Utilization of angiography in trauma.

In conclusion, I have tried to present a rational approach to the work-up of the traumatized patient. One must consider the mechanism of injury, the region where the most damage has been inflicted, and, most important of all, the clinical condition in which the patient arrives. With injuries in most of the body parts, there will not be time to perform any angiographic procedure in category 1 patients. They may or may not have intraoperative or postoperative angiograms. Category 2 patients benefit most from angiography; therapy will often be dictated based on the results. Category 3 patients are studied as necessary; the decision is made with strong consideration given to the type of trauma and the proximity of major vessels. For all groups of patients, angiography should be performed as soon as possible to avoid the sequelae of delay in treatment, as pointed out previously, particularly delayed rupture of arteries. This is becoming increasingly important as angiography has started to play a bigger role in the early therapeutic intervention of the traumatized patient. It is expected that appropriate and increasing use of arteriography will improve organ, limb, and patient salvage by early surgical or transcatheter techniques.