Some considerations in the patient with a penetrating vascular injury (gunshot, stab):
Obtain ankle-brachial index on all patients and document
An ABI <0.9 indicates the need to perform an arterial study
Traditional approach to penetrating extremity injury has been to perform angiography
Recent (good) studies have shown that CTA of the involved extremity is just as good if not better than angiography, and a lot of centers have moved to CTA
Obtain vascular surgery consultation if there is any concern for an arterial injury. Never hurts to err on the side of caution.
