Vascular Trauma Flashcards
What are the appropriate investigations in suspected arterial bleeds?
Angiography
Contrast CT
How should arterial transection be managed?
Haemorrhage - pressure via gauze swabs
Ischaemia - vascular grafting/repair
ALWAYS REPAIR VV FIRST
What is an AVF?
Acquired communication b/w an artery and a vein
What are the causes of an AVF?
Penetrating trauma
Erosion of aneurysm into vv
Iatrogenic (haemodilaysis)
What is the pathophysiology behind an AVF?
Shunting from aa —> vv
Increased flow causes dilation/thickening of vv (arterialization)
Peripheral arterial resistance drops –> LVF
What are the sx of an AVF?
Limb heaviness
- worse w/ dependency
- relieved by elevation
What are the signs of an AVF?
Oedema
Prominent vv
Audible murmur/palpable thrill in vv
Signs of CCF
What investigations are appropriate in suspected AVF?
ABG - high O2 distal to AVF
Clotting - coagulopathies
Duplex USS/contrast CT
How are AVFs managed?
Surgery/interventional radiology
