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- W2913201580 abstract "Le pronostic des atteintes artérielles traumatiques, conséquences de polytraumatismes, de traumatismes pénétrants ou iatrogènes, dépend du risque ischémique d’aval et d’un éventuel syndrome hémorragique, justifiant un bilan exhaustif et une prise en charge rapides. Le diagnostic repose en premier lieu sur l’examen clinique, dont la normalité n’exclut pas formellement des lésions vasculaires : au moindre doute un complément par écho doppler ou tomodensitométrie (TDM) est nécessaire. Si l’artériographie demeure le gold standard, ses indications sont aujourd’hui plus électives, signifiant la possibilité de méconnaître des lésions qui se manifesteront avec retard : c’est dire alors l’importance du suivi. Dans le cadre d’une étroite collaboration multidisciplinaire, l’artériographie peut constituer le premier temps d’une embolisation d’hémostase ou de la restauration de continuité par stent ou stent-graft. Ces techniques endovasculaires sont moins délabrantes que la chirurgie ouverte, notamment pour les régions difficilement accessibles, comme les territoires sous-clavier ou axillaire où le risque d’atteinte du plexus brachial est également réduit. Au niveau des membres inférieurs, les lésions focales fémorales et ischémiques sous-poplitées se prêtent tout particulièrement à la radiologie interventionnelle.The prognosis of traumatic arterial damage and the consequences of polytrauma or of penetrating or iatrogenic trauma depends on the downstream ischemic risk and possible bleeding disorder warranting an exhaustive review and rapid management. The diagnosis is based primarily on the physical examination, although a normal exam does not formally exclude vascular injury. If there is any doubt, further exploration with Doppler ultrasound or computed tomography (CT) is necessary. Angiography remains the gold standard, but its indications are now more elective such that injuries occurring late may be missed, underscoring the importance of monitoring. As part of a close multidisciplinary collaboration, arteriography may be the first time in an embolization or reconstruction process (stent, stent-graft). These endovascular techniques are less debilitating than open surgery, especially for hard to reach areas such as the subclavian or axillary territories where the risk of injuring the brachial plexus is also reduced. In the lower limbs, focal femoral and ischemic infrapopliteal lesions are particularly suitable for interventional radiology." @default.
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- W2913201580 date "2015-04-01" @default.
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- W2913201580 title "Lésion osseuse de nature rare" @default.
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- W2913201580 doi "https://doi.org/10.1016/j.frad.2014.12.010" @default.
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