Vascular injury poses a serious threat to limb and life.
Thus,
diagnosis should be made immediately with minimally invasive methods.
Doppler is a good aid in diagnosis of vascular injury.
Traumatic injuries are one of the most frequent reasons for urgency consultation and are also the leading cause of death in people under 40 years of age.
A high percentage of vascular injuries are secondary to trauma such as,
fractures,
gunshot wounds,
sharps injuries,
traffic accidents,
stabbing,
and blast injury,
also occupational and iatrogenic injuries,
bringing along a high morbidity and mortality. An early diagnosis and trauma team response,
are decisive for the outcome of the patient.
Fig. 31
The role of Vascular Color Doppler ultrasound (CDUS) in the diagnosis of these pathologies is not well determined.
In the context of a trauma patient with the suspicion of having a peripheral vascular injury,
this method can be a quick,
and most of the times,
accurate tool to diagnose the most frequent vascular pathologies,
in the hands of a trained operator. It is useful for flow analysis and for follow-up after treatment.
However,
some limitations inherent to sonography,
such as bones,
subcutaneous air,
large haematomas,
casts,
large skin wounds or skin burns,
impede CDUS performance.
Aberrant vessels and some anatomic areas are difficult to scan.
Further limitations are derived from operator dependence and lengthy examinations, which may be inappropriate in the acute care setting.
Despite these limitations,
CDUS is presently considered the first-line examination for evaluation of vascular injuries.
Some publications in critical ultrasound are beginning to use the name ¨Fast D protocol¨ comparing it with ¨Ecofast¨ evaluation 1-2.
We aim to make an academic review of the most frequent types of peripheral traumatic vascular lesions,
illustrating them with CDUS images and showing also correlation with angio CT scans.