Evaluation and Management of Peripheral
Annotation for Point N
An intimal defect documented on an imaging study is expected to heal 87% to 95% of the time without operation. 33,57 In the absence of injuries to the brain, solid viscera of the abdomen, or extensive soft tissue wounds, some centers will initiate prophylaxis against thrombosis with heparin or aspirin during the period of observation. A patient who maintains flow to the hand or foot and has no clinical findings suggestive of a developing pseudoaneurysm or arteriovenous fistula is discharged home at the discretion of the attending surgeon. The patient is then reexamined in the outpatient clinic (see Note G). Patients who develop abrupt changes in perfusion to the hand or foot or signs of a new pseudoaneurysm or arteriovenous fistula undergo urgent diagnostic imaging.