Traumatic injuries to the subclavian and axillary arteries: a 13-year review.
OBJECTIVE
By reviewing our experience, we evaluated the presentation, management, and long-term outcome of patients with subclavian and axillary artery injuries resulting from trauma.


METHODS
We retrospectively reviewed the data of 38 patients who received treatment for subclavian or axillary artery injuries in the Emergency and Trauma Department of Medical Faculty of Istanbul, Istanbul University between January 1989 and July 2002.


RESULTS
Arterial injuries were repaired with an end-to-end anastomosis in 10 (26.3%) patients, primary repair in 6 (15.7%), autologous vein graft interposition in 16 (42%), ligation in 5 (13.1%), and a proximal subclavian-brachial artery bypass in 1 (2.6%). One (2.6%) of the arterial reconstructions failed in the perioperative period. Fourteen (36%) patients presented with a neurological deficit, which recovered after the intervention in 2 (5.2%) patients. A wound infection developed in 8 (21%) patients and 2 (5.2%) patients died of concomitant injuries. Thirteen (36.1%) of the remaining 36 patients were followed up for a mean period of 7 months.


CONCLUSIONS
Successful management of subclavian and axillary artery injuries requires prompt diagnosis because the occult nature of these injuries necessitates a high index of suspicion. Although revascularization procedures are often successful, it is the associated neurological, orthopedic, and soft tissue injuries that affect the functional outcome of the limb.
Department of General Surgery, Istanbul Medical Faculty, Istanbul University, Turgut Ozal Cad., Capa 34310, Istanbul, Turkey.
Murat
M
Aksoy
Fatih
F
Tunca
Hakan
H
Yanar
Recep
R
Guloglu
Cemalettin
C
Ertekin
Mehmet
M
Kurtoglu
D000293:Adolescent; D000328:Adult; D000465:Algorithms; D001366:Axillary Artery / Q000293:injuries*; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D013348:Subclavian Artery / Q000293:injuries*; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000379:methods*; D014949:Wounds, Nonpenetrating / Q000175:diagnosis / Q000601:surgery*; D014950:Wounds, Penetrating / Q000175:diagnosis / Q000601:surgery*