An Atypical Presentation of Vascular Injury in Extremity Trauma Beyond Current Guidelines
Year: 2025
Type: article
Study design: Case Report
Abstract: CT angiography (CTA) is a key diagnostic tool for evaluating vascular injuries in trauma patients. Current guidelines from the Eastern Association for the Surgery of Trauma (EAST) recommend CTA when there are abnormal physical findings or an ankle-brachial index (ABI) ≤ 0.9. We present the case of a 32-year-old male with a gunshot wound to the thigh who had a normal ABI and did not meet the established criteria for imaging. However, CTA was performed due to subtle signs, including distal limb swelling, and revealed a traumatic femoral arteriovenous fistula. The patient subsequently underwent successful endovascular repair. This case highlights the limitations of existing guidelines and underscores the continued importance of a thorough physical examination, a high index of suspicion, and sound clinical judgment.
Source: Cureus
DOI: 10.7759/cureus.90413
Authors: Taylor Broudy, Logan Gonsalves, Jonathan King, Kakra Hughes, Alexander Evans
Institutions: Howard University, Howard University Hospital
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4413272522