diagnostic modalities in vascular trauma

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Honorable members

What would be your approach to a patient with high velocity penetrating
extermity injury with normal distal pulses, soft signs (nerve injury, as an
example) or proximity injury (< 1 cm between the course of the bullet and a
large named artery).
The literature I know of mainly talks about civilian trauma, which means low
velocity bullets. According to that literature there is no place for angio
in this setting and the way to treat those patients is according to PE
findings. ERF wrote in the J of Trauma in 1989 and 1991 about the importance
of PE examination as the sole indication, in such settings, to decide which
of those patients needs angio.
Eric, what do you say ?

Eitan Heldenberg, Israel

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