Duplex scanning for arterial trauma

Duplex sonography was evaluated as a potential screening examination for arterial trauma in 89 patients with 93 injuries, mostly to the extremities (n = 74) or the cervicothoracic region (n = 17). Among 60 scans performed solely because of wound proximity to nearby vascular structures, 4 (6.7%) were positive. Thirteen of 19 (68%) scans performed for clinical indications were positive. Six of 12 (50%) postoperative studies were abnormal, and each of 4 arterial injuries followed serially remained stable. Four false-negative duplex scans (4.3%) were recorded; no major arterial injuries were missed, and no false-positive studies were noted. Duplex sonography is rapid, noninvasive, inexpensive, and portable. Since it also appears to be reliable in diagnosing and localizing sites of arterial disruption, duplex scanning may be of value in screening patients with trauma for the presence of occult vascular injuries.