1887
Volume 2012, Issue 1
  • ISSN: 1999-7086
  • EISSN: 1999-7094

Abstract

Subclavian artery injuries are rare in blunt chest trauma, constituting just 1–2 percent of all acute vascular injuries. The diagnosis of injury to the subclavian artery is challenging as a good percentage of patients with such vascular injuries have palpable distal pulses, no signs of any external local trauma and associated injuries often divert the attention of treating physicians. Subclavian artery injuries are the second most common injuries to occur to the aortic arch vessels. The mechanism of injury to these vessels varies from deceleration to traction on upper extremity and neck. Angiography is vital in diagnosis and surgical planning of these patients depends on the site and side of the vascular injuries. Early surgical treatment is an important part of management of these patients. Endovascular treatment is of value in a selected subgroup of subclavian artery injury patients. Reported mortality of subclavian artery injuries varies according to haemodynamic status of patient, time of presentation and other associated injuries. A high degree of suspicion is key to diagnosing these vascular injuries. Early appropriate surgical repair of vascular injury, in combination with aggressive treatment of associated injuries, is important for the optimal outcome of these cases. Here we report three cases of subclavian artery injury, which were successfully treated in Hamad General Hospital by vascular surgery and intensive care teams.

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2013-06-01
2024-03-29
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References

  1. Johnson SF, Johnson SB, Strodel WE, Barker DE, Kearney PA. Bracial plexuses injury associated with subclavian and axillary vascular injury. J Trauma. 1991 31:11:15461550
    [Google Scholar]
  2. Bosher LH, Freed TA. The surgical treatment of traumatic rapture or avulsion of innominate artery. J Thoracic Cardio Vasc Surg. 1967 54::732739
    [Google Scholar]
  3. George SM, Croce MA, Fabian TC. Cervithoracic arterial injuries, recommendations for diagnosis and management. World J Surg. 1991 15::134140
    [Google Scholar]
  4. Castagna J, Nelson RJ. Blunt injuries to the branches of the aortic arch. J Thorasc Cardiovasc Surg. 1975 69::521531
    [Google Scholar]
  5. Anjum SN, Sanger R, Wake P. Unusual subclavian artery injury following clavicle fracture resulting from epileptic fit. Injury. 2004 36:5:110114
    [Google Scholar]
  6. Tsutsumi K, Saito H, Ohkura M. Traumatic pseudoaneurysm of the subclavian artery following anterior dislocation of the shoulder: a report of a surgical case. Ann Thorac Cardiovasc Surg. 2006 12:1:7476
    [Google Scholar]
  7. Divyan P, Keshava SN, Nayak S, Agarwal S, Chiramal GK. Delayed presentation of a post-traumatic subclavian pseudoaneurysm. Vasc Dis Manage. 2007 4:6:171173
    [Google Scholar]
  8. Binet JP. A case of traumatic avulsion of innominate artery at its origin from aortic arch. J Thoracic Cardio Vasc Surg. 1962 43::670676
    [Google Scholar]
  9. Rosenberg JM, Brandenburg CE, Marvasti MA, Bucknam C, Conti C, Parker FB Jr. Blunt injuries to aortic arch vessels. Ann Thoracic Surg. 1989 48::508513
    [Google Scholar]
  10. Franz JL, Simpson CR, Penny RM, Grover FL, Trinkle JK. Avulsion of innominate artery after blunt chest trauma. J Thoracic Cardio Vasc Surg. 1974 67::478480
    [Google Scholar]
  11. Hajarizadel H, Roher JM, Cutler BS. Surgical exposer of left subclavian artery by median sternotomy and left supraclavicular extension. J Trauma. 1996 41::136139
    [Google Scholar]
  12. Juszkat R, Stanisic M, Dzieciuchowicz L, Staniszewski R, Pukacki F, Oszkinis G, Majewski W. Traumatic injuries to subclavian arteries treated with stent graft implantation. Pol Przegl Chirurgiczny. 2007 79:1:2935
    [Google Scholar]
  13. Thalhammer C, Kirchherr AS, Uhlich F, Waigand J, Gross CM. Post catheterization pseudoaneurysms and arteriovenous fistulas: repair with percoutanous implantation of endovascular covered stents. Radiology. 2000 214::127131
    [Google Scholar]
  14. Jeffrey SD, Anthony DC, Michael CS, Rao RI, Mark ML. Feasibility of endovascular repair in penetrating axillosubclavian injuries: a retrospective review. J Vasc Surg. 2005 41:2:246254
    [Google Scholar]
  15. Prêtre R, Hoffmeyer P, Bednarkiewicz M, Kursteiner K, Faidutti B. Blunt injury to the subclavian artery. J Am Coll Surg. 1994 179::295298
    [Google Scholar]
  16. Cox CS Jr, Allen GS, Fischer RP, Conklin LD, Duke JH, Cocanour CS, Moore FA. Blunt versus penetrating subclavian artery injury: presentation, injury pattern and the out-come. J Trauma. 1999 46::445449
    [Google Scholar]
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