Management of subclavian and axillary artery injuries: spanning the range of current therapy.
Injuries of the subclavian and proximal axillary arteries are potentially devastating but account for a minority of vascular injuries presenting to trauma centers in the United States. We have reviewed our recent experience with management of subclavian and axillary artery injuries in a state-designated level 1 academic trauma center and report four cases that illustrate the typical arterial injury patterns and the entire therapeutic armamentarium in its current iteration. Subclavian and proximal axillary artery injuries present as interesting surgical problems. A high index of suspicion for vascular injuries should be maintained given the mechanism and proximity to major vasculature. Consideration should always be given to the least invasive treatment options in stable patients. Awareness of multiple therapeutic modalities and indications for each should be an integral part of every surgeon's armamentarium. As with all vascular intervention, eventual failure is the rule rather than the exception; therefore, plans for longitudinal surveillance should be made independent of the technique used to treat the injury.
Franga
Dion L
DL
Department of Surgery, Medical College of Georgia, Augusta, Georgia 30912, USA.
Hawkins
Michael L
ML
Mondy
J Sheppard
JS
D000293:Adolescent; D000328:Adult; D000792:Angiography; D000925:Anticoagulants / Q000627:therapeutic use*; D001366:Axillary Artery / Q000187:drug effects / Q000293:injuries* / Q000601:surgery; D005500:Follow-Up Studies; D005547:Foreign Bodies / Q000000981:diagnostic imaging / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000000981:diagnostic imaging / Q000628:therapy*; D019651:Plastic Surgery Procedures / Q000379:methods; D013348:Subclavian Artery / Q000187:drug effects / Q000293:injuries* / Q000601:surgery; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000379:methods*; D014948:Wounds, Gunshot / Q000000981:diagnostic imaging / Q000628:therapy; D014951:Wounds, Stab / Q000000981:diagnostic imaging / Q000628:therapy
D000925:Anticoagulants