Evaluation and Management of Peripheral
Vascular Injury
Part 1

Annotation for Point D

If a hard sign of arterial injury is present, but localization of the defect is necessary (i.e., shotgun wound or multiple fractures), two rapid options are available. Either a preliminary surgeon-performed arteriogram is performed in the emergency center or operating room or a duplex ultrasonography study is performed by an experienced vascular surgeon or registered vascular technologist if it can be done in a timely fashion.26–28