Σάββατο 10 Ιουνίου 2017

Frostbite, Injury, and Trauma in the Extremities

Abstract

Purpose of Review

The objective of the study is to review the current methods of evaluating and managing both frostbite injury and non-thermal extremity vascular trauma, with an emphasis on endovascular techniques.

Recent Findings

The traditional management of frostbite has a well-established role for the rapid rewarming of injured tissues. This literature review highlights the evolution of the various management techniques with a specific focus on the more recent role of intra-vascular catheter-directed thrombolytic therapy. Non-thermal extremity trauma with resulting vascular injury requires prompt diagnosis that relies heavily on both the physical examination and the appropriate imaging.

Summary

Frostbite injury manifests as a progressive insult with distinct pathophysiologic phases during which imaging can guide appropriate care. Traditional medical management, in combination with intra-vascular catheter-directed thrombolytic regimens, can restore blood flow to poorly or non-perfused digits, thereby ultimately reducing the risk of delayed amputation. Non-thermal trauma to the extremities can result in a variety of vascular injuries. Interventional radiology plays a key role in diagnosis and an expanding role using transcatheter therapies in order to provide efficacious and optimal management of patients with vascular injury.



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