Endovascular treatment of penetrating thoracic outlet arterial injuries.
OBJECTIVE
to establish the feasibility of stent-graft treatment of penetrating thoracic outlet arterial injuries.


METHODS
prospective study.


METHODS
forty-one patients with penetrating injuries to the carotid, subclavian and proximal axillary arteries admitted between August 1998 and May 1999 were studied. Patients requiring urgent surgical exploration for active bleeding (n=26) were excluded. Remaining patients underwent arteriography to assess suitability for stent-graft placement. After successful stent-graft treatment clinical and sonographic follow-up were done at 1 month and thereafter 3-monthly.


RESULTS
of the 15 patients considered, 10 patients qualified for stent-graft treatment (seven male, three female, mean age 27 years). The vessels involved were subclavian artery (seven), carotid artery (two) and axillary artery (one). Seven had arteriovenous fistulae and three, pseudoaneurysms. Stent-graft treatment was successful in all 10 patients with no procedure-related complications. On mean follow-up of 7 months no complications were encountered.


CONCLUSIONS
endovascular treatment shows promise as a treatment modality for thoracic outlet arterial injuries. Long-term follow-up is required for comparison to the results of standard surgical repair.
du Toit
D F
DF
Department of Surgery, Tygerberg Hospital and the University of Stellenbosch, Tygerberg, South Africa.
Strauss
D C
DC
Blaszczyk
M
M
de Villiers
R
R
Warren
B L
BL
D000293:Adolescent; D000328:Adult; D017541:Aneurysm, False / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy; D000792:Angiography; D001164:Arteriovenous Fistula / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy; D001366:Axillary Artery / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D001672:Biocompatible Materials; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation; D020212:Carotid Artery Injuries / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D004621:Embolization, Therapeutic; D005260:Female; D006801:Humans; D008297:Male; D011138:Polytetrafluoroethylene; D011446:Prospective Studies; D013348:Subclavian Artery / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D013898:Thoracic Injuries / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome; D014950:Wounds, Penetrating / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*
D001672:Biocompatible Materials; D011138:Polytetrafluoroethylene