title: Percutaneous treatment of traumatic upper-extremity arterial injuries: a single-center experience.
abstract: To assess the feasibility and effectiveness of emergency percutaneous treatment of traumatic injuries of upper-extremity arteries.
  
  
  
  Between January 2000 and December 2007, 11 patients (mean age, 49.9 years) with traumatic injuries of upper-extremity arteries were observed: three had pseudoaneurysms, four had dissections, three had transections, and one had mural hematoma. Lesions involved the axillary (n = 6), subclavian (n = 3), or brachial artery (n = 2). Pseudoaneurysms and transections were treated with stent grafts, (n = 6) and dissections and mural hematomas were treated with bare stents (n = 2) or angioplasty (n = 3). Follow-up (mean, 45.1 months; range, 12-84 months) was performed with color Doppler ultrasonography at 1, 3, 6, and 12 months and then, yearly.
  
  
  
  Immediate technical success was obtained in all cases. No major complications occurred; there was one asymptomatic occlusion of the interosseous artery and one case of incomplete thrombosis of the radial artery (with recanalization after 1 month with systemic medical therapy). During a mean follow-up of 45.1 months, one stent-graft occlusion occurred, which was treated with intraarterial pharmacologic thrombolysis (urokinase 60,000 IU/h for 12 hours). Overall primary clinical success rate was 95.2% and secondary clinical success rate was 100%.
  
  
  
  Percutaneous treatment is a feasible and safe tool for injuries of upper-extremity arteries because it can provide a fast and definitive termination of bleeding or a resolution of acute ischemia. This approach, with its low invasiveness, can be proposed as first-line treatment in patients with traumatic lesions of upper-extremity arteries.
authors.affiliation: Interventional Radiology Research Centre, Department of Radiology, Insubria University, Ospedale di Circolo e Fondazione Macchi, Viale Borri, Varese, 21100 Italy. gcarraf@tin.it
authors.forename: Gianpaolo
authors.initials: G
authors.lastname: Carrafiello
authors.forename: Domenico
authors.initials: D
authors.lastname: Laganà
authors.forename: Monica
authors.initials: M
authors.lastname: Mangini
authors.forename: Federico
authors.initials: F
authors.lastname: Fontana
authors.forename: Chiara
authors.initials: C
authors.lastname: Recaldini
authors.forename: Filippo
authors.initials: F
authors.lastname: Piacentino
authors.forename: Carlo
authors.initials: C
authors.lastname: Pellegrino
authors.forename: Gabriele
authors.initials: G
authors.lastname: Piffaretti
authors.forename: Carlo
authors.initials: C
authors.lastname: Fugazzola
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000784:Aortic Dissection / Q000628:therapy; D017541:Aneurysm, False / Q000628:therapy; D017130:Angioplasty; D001366:Axillary Artery / Q000000981:diagnostic imaging / Q000293:injuries*; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation; D001916:Brachial Artery / Q000000981:diagnostic imaging / Q000293:injuries*; D002648:Child; D057510:Endovascular Procedures / Q000009:adverse effects / Q000295:instrumentation; D005240:Feasibility Studies; D005260:Female; D006083:Graft Occlusion, Vascular / Q000188:drug therapy / Q000209:etiology; D006406:Hematoma / Q000628:therapy; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015607:Stents; D013348:Subclavian Artery / Q000000981:diagnostic imaging / Q000293:injuries*; D015912:Thrombolytic Therapy; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D018615:Ultrasonography, Doppler, Color; D034941:Upper Extremity / Q000098:blood supply*; D057772:Vascular System Injuries / Q000000981:diagnostic imaging / Q000628:therapy*; D055815:Young Adult