1: J Vasc Interv Radiol  1997 Jan-Feb;8(1 Pt 1):43-53 

Natural history of arterial injuries diagnosed with arteriography.

Hoffer EK, Sclafani SJ, Herskowitz MM, Scalea TM.

Department of Radiology, State University of New York, Health Science Center at
Brooklyn 11203, USA.

PURPOSE: To evaluate the natural history of untreated arterial injuries
identified at arteriography. MATERIALS AND METHODS: The medical charts and
radiographs were reviewed for all patients with arterial injuries identified
during arteriography who were managed by means of nonoperative observation and
underwent follow-up arteriography. RESULTS: Eighty-six nonrandomized patients
with 105 arterial injuries were identified. These included 33 narrowed segments,
two dilated segments, 23 intimal defects, 13 occlusions, 12 false aneurysms, 13
arteriovenous fistulas (AVFs), and five extravasations. Four vessels initially
considered normal were subsequently found to have injuries. The average duration
of observation was 23.5 days (range, 1-1,900 days). Forty-two arterial
abnormalities healed spontaneously without other intervention. Thirty-eight
"minimal" injuries improved or healed, whereas 25 worsened. Thirteen transmural
injuries improved, whereas 12 progressed. There was no significant morbidity or
mortality due to the delay involved with sequential studies. CONCLUSIONS: The
natural history of these abnormalities was variable and unpredictable.
Nonocclusive "minimal" injuries rarely cause ischemic or hemorrhagic
complications. Although symptomatic AVFs have a low probability of spontaneous
resolution, asymptomatic lesions may close and the risks associated with a few
months of observation are minimal. Close follow-up is essential if a
nonoperative approach is undertaken.

PMID: 9025038 [PubMed - indexed for MEDLINE]