A Reappraisal of Exclusion Angiography in Gunshot Wounds of the Extremities

Francois I. Luks, Daniel L. Picard, Walter F. Pizzi, Steven A. Battaglia, Henry R. Lamaute

Research output: Contribution to journalArticlepeer-review


The routine use of exclusion angiography in trauma to the extremities has resulted in varying percentages of negative studies, mostly because of a great variability in location and type of injury. The authors reviewed 117 low-velocity gunshot wounds to the extremities. Twenty-six cases presented with hard signs of vascular injury and underwent immediate exploration. Ninety-one exclusion angiograms were performed (11 for soft signs and 80 for proximity only), 89 (98%) were considered negative. Two cases (2 %) that presented without hard signs required vascular repair. Physical examination alone was 93 % sensitive and 99 % specific for recognition of vascular injuries. Routine angiography did not substantially improve the diagnostic accuracy and had a positive predictive value of only 2%. The authors conclude that angiography may be safely omitted in low-velocity gunshot wounds to the extremities if the absence of signs or symptoms of vascular injury can be firmly established.

Original languageEnglish (US)
Pages (from-to)295-300
Number of pages6
JournalVascular and endovascular surgery
Issue number4
StatePublished - May 1991
Externally publishedYes

ASJC Scopus subject areas

  • Surgery
  • Cardiology and Cardiovascular Medicine


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