Duplex scanning replaces arteriography and operative exploration in the diagnosis of potential cervical vascular injury. Discussion.
Southwestern Surgical Congress. Annual meeting. Tucson AZ USA, 1994/04/17.
The pursuit of a diagnosis is more aggressive in suspected cervical vascular injury than in extremity vascular proximity injury, since the complications of missing the neck injury may result in irreversible neurologic damage.
Most institutions use arteriography and operative exploration, but these modalities identify only 10% of cervical vascular traumas.
While duplex scaring is the screening test of choice for carotid occlusive disease, few published reports have described experience with this modality in cervical vascular trauma.
PATIENTS AND METHODS
To determine if duplex scaring can replace arteriography or operative exploration as the initial screening modality in the assessment of potential cervical vascular trauma, we performed a prospective evaluation in two parts.
First, we used duplex scanning and cervical arteriography, concomitantly, to rule out injury in 15 patients.
We then used duplex scanning alone in 85 patients, reserving arteriography for cases in which the scan revealed an arterial injury.
Duplex scans and arteriography and operation diagnosed cervical vascular trauma equally well.
Eight injuries were identified in all areas of the cervical arterial tree.
No duplex scans have been falsely negative or falsely positive.
Use of duplex scans instead of arteriography saved $1,252 per case.
Mots-clés Pascal : Appareil circulatoire pathologie, Vaisseau sanguin pathologie, Traumatisme, Diagnostic, Homme, Etude comparative, Exploration ultrason, Dopplérométrie, Echographie, Radiodiagnostic, Artériographie, Chirurgie, Cou, Vaisseau sanguin, Blessure, Californie, Etats Unis, Amérique du Nord, Amérique, Coût
Mots-clés Pascal anglais : Cardiovascular disease, Vascular disease, Trauma, Diagnosis, Human, Comparative study, Sonography, Doppler ultrasound study, Echography, Radiodiagnosis, Arteriography, Surgery, Neck, Blood vessel, Injury, California, United States, North America, America, Costs
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Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 95-0226266
Code Inist : 002B24C01. Création : 09/06/1995.