Emergency room retrograde transbrachial arteriography for the management of axillosubclavian vascular injuries

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dc.contributor.authorAerts, N. R.
dc.contributor.authorFigueiredo, LFP de
dc.contributor.authorBurihan, E.
dc.contributor.institutionUniversidade Federal de São Paulo (UNIFESP)
dc.contributor.institutionPronto Socorro Hosp
dc.date.accessioned2016-01-24T12:33:56Z
dc.date.available2016-01-24T12:33:56Z
dc.date.issued2003-07-01
dc.description.abstractBackground: our purpose was to determine the accuracy of single-injection, retrograde transbrachial arteriography (RTBA), performed in the emergency room, for suspected axillosubclavian injuries.Methods: Thirty-three patients were prospectively assigned for RTBA. Clinical indications for RTBA included high-risk mechanism of injury, decreased (n = 19) or absent (n = 5) brachial pulse, neurologic deficits (n = 11), external or intrathoracic bleeding (n = 4), and bruit (n = 2). Brachial artery was cannulated with an 18-gauge catheter. A sphygmomanometer cuff was placed at the forearm and inflated to 250 mm Hg. Twenty milliliters of nonionic contrast media was injected countercurrent and a single anteroposterior chest radiograph was obtained. Small intimal flaps were followed by serial ultrasound. Surgical findings were used to establish RTBA accuracy.Results. RTBA was successfully performed in all cases. Arterial lesions were detected in 28 (84.8%) patients, including thrombosis (n = 8), arteriovenous fistula (n = 8), and false aneurysm (n = 7) as the most frequent lesions. A sensitivity of 96.5%, a specificity of 100%, a positive predictive value of 100%, and a negative predictive value of 80% were observed with RTBA.Conclusion. We conclude that RTBA is a safe and accurate technique to be used in the emergency room for the rapid detection of axillosubclavian arterial injuries.en
dc.description.affiliationUniversidade Federal de São Paulo, Dept Surg, UNIFESP, EPM, São Paulo, Brazil
dc.description.affiliationPronto Socorro Hosp, FFFCMPA, Porto Alegre, RS, Brazil
dc.description.affiliationUnifespUniversidade Federal de São Paulo, Dept Surg, UNIFESP, EPM, São Paulo, Brazil
dc.description.sourceWeb of Science
dc.format.extent69-73
dc.identifierhttp://dx.doi.org/10.1097/01.TA.0000073135.07925.B7
dc.identifier.citationJournal of Trauma-injury Infection and Critical Care. Philadelphia: Lippincott Williams & Wilkins, v. 55, n. 1, p. 69-73, 2003.
dc.identifier.doi10.1097/01.TA.0000073135.07925.B7
dc.identifier.issn0022-5282
dc.identifier.urihttp://repositorio.unifesp.br/handle/11600/27317
dc.identifier.wosWOS:000187276500012
dc.language.isoeng
dc.publisherLippincott Williams & Wilkins
dc.relation.ispartofJournal of Trauma-injury Infection and Critical Care
dc.rightsAcesso restrito
dc.subjectaccuracyen
dc.subjectarteriographyen
dc.subjectaxillosubclavian traumaen
dc.subjectbleedingen
dc.subjectvascular traumaen
dc.titleEmergency room retrograde transbrachial arteriography for the management of axillosubclavian vascular injuriesen
dc.typeArtigo
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