Arterial trauma: diagnostic and therapeutic angiography.

Between 1978 and 1982, 1,200 patients underwent angiography following acute traumatic injury, and arterial injuries were detected in 182 cases (15.2%). Two-thirds of the cases were associated with penetrating trauma; half the injuries occurred in the pelvis or lower extremities. The most common and reliable sign of arterial injury was the presence of extraluminal contrast media. Other signs included occlusion, laceration, transection, arteriovenous fistula, intimal flap, and intraluminal thrombus. Luminal narrowing was difficult to interpret and resulted from a variety of causes, some of which do not require surgical intervention. Embolotherapy to control arterial bleeding was attempted in 79 patients (43%), and hemostasis was achieved in 69 of them (87%). Transcatheter closure was attempted in 19 of 34 arteriovenous fistulas, resulting in complete success in 15 cases and partial success in two.