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Hand (N Y). 2009 June; 4(2): 194.
Published online 2008 October 4. doi:  10.1007/s11552-008-9139-6
PMCID: PMC2686784

Pediatric Extremity Multidetector CT Angiography

Dear Editor,

We read the article with great interest by Hsu et al. in your journal about the use of computed tomography-angiography (CTA) for the evaluation of traumatic injuries in pediatric patients [1]. The authors listed many applications of CTA in pediatric patients. I am surprised that they forgot to mention the first report on pediatric extremity multidetector CT angiography [2]. In that article, we described our experience in six patients who underwent pediatric extremity multidetector CTA with congenital anomalies prior to reconstructive surgery, suspected arterial occlusion, and an extremity mass. We also recently retrospectively analyzed and submitted our experience after the initial series of six patients which includes 20 pediatric patients, and most of these patients underwent extremity CTA after trauma. We definitely agree that in pediatric patients, conventional angiography is too invasive and should be reserved for patients who will undergo endovascular treatment. Also, for trauma patients, early diagnosis of vascular injuries is essential to prevent further complications. In our institution, we have excellent collaboration with our trauma surgeons, and they prefer extremity CTA to conventional angiography most of the time. I congratulate the authors for their article which will lead to wider utilization of this technique.

References

1. Hsu CS, Hellinger JC, Rubin GD, Chang J. CT angiography in pediatric extremity trauma: preoperative evaluation prior to reconstructive surgery. Hand 2008;3:139–45. doi:10.1007/s11552-007-9081-z. [PMC free article] [PubMed]
2. Karcaaltincaba M, Akata D, Leblebicioglu A, et al. MDCT angiography of the extremities in pediatric patients: initial experience. AJR Am J Roentgenol. 2004;183:189–92. [PubMed]

Articles from Hand (New York, N.Y.) are provided here courtesy of American Association for Hand Surgery