Emergent axillary artery stent-graft placement for massive hemorrhage from an avulsed subscapular artery.
OBJECTIVE
To report the successful endovascular repair of an acute axillary artery hemorrhage.


METHODS
An 87-year-old woman with Charcot-Marie-Tooth ataxia presented with an enormous shoulder hematoma and clinical signs of exsanguination after a fall. Angiography demonstrated complete avulsion of the right subscapular artery from the axillary artery, and active bleeding into a hematoma of at least 1500 mL. Endovascular repair with a balloon-mounted covered stent-graft was performed percutaneously, which controlled the bleeding and averted surgery. The patient recovered uneventfully and was without signs of recurrent bleeding or ischemia on the 6-month ultrasound examination; she reports no symptoms referable to her upper extremity after 14 months.


CONCLUSIONS
Endovascular repair with stent-grafts is effective in controlling arterial bleeding from supra-aortic vessels even under emergency conditions.
Dinkel
Hans-Peter
HP
Department of Radiology, Inselspital Bern, University of Bern, Switzerland. hans-peter.dinkel@insel.ch
Eckstein
Friedrich S
FS
Triller
Jürgen
J
Do
Dai-Do
DD
D000058:Accidental Falls; D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography / Q000379:methods; D001366:Axillary Artery / Q000293:injuries*; D021721:Balloon Occlusion / Q000295:instrumentation / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006470:Hemorrhage / Q000000981:diagnostic imaging* / Q000209:etiology / Q000628:therapy*; D006801:Humans; D012421:Rupture / Q000000981:diagnostic imaging / Q000628:therapy; D012540:Scapula / Q000098:blood supply; D012720:Severity of Illness Index; D000070599:Shoulder Injuries; D015607:Stents; D016896:Treatment Outcome