Utility of Multidetector Computed Tomography Angiography in evaluation of post traumatic neglected vascular injuries of the upper extremity

Vascular injuries of the upper limb are rare, and CT angiography (CTA) may be performed to assess vascular complications in neglected trauma patients. The aim of this study was to evaluate the role of CTA in evaluation of neglected vascular injuries. This prospective study included 20 patients with previous trauma history, with clinically suspected vascular lesion. CTA was done for all patients followed by surgical treatment. CTA detects pseudoaneurysm in 11 (55%) patients, stenosis in 5 (25%) patients, total occlusion in 2 (10%) patients, and arteriovenous fistula (AVF) in 2 (10%) patients. One patient (5%) had metallic artifact that alters image interpretation. The accuracy of CTA in detecting vascular lesion in the examined patients was 95% with sensitivity and specificity of 95% and 100%, respectively. MDCT angiography is highly accurate initial noninvasive diagnostic tool for the evaluation of vascular abnormalities of the upper extremity arterial system in patients with suspected neglected extremity trauma. Limitation of CTA examination was the presence of metallic artifact adjacent to the examined arteries.