title: Endovascular repair of blunt axillo-subclavian arterial injuries as the first line treatment.
abstract: OBJECTIVE
  To report and analyse our results regarding the endovascular management of blunt axillo-subclavian arterial injuries as the first line treatment.
  
  
  METHODS
  During an eight-year period, seven patients (mean age 56.4±14.1 years, all males) with blunt traumatic axillo-subclavian arterial injuries were presented to the emergency department. All patients suffered also from concomitant other injuries and had a supraclavicular haematoma along with diminished or absent upper limb peripheral pulses, while computed tomography angiography set the diagnosis.
  
  
  RESULTS
  The endovascular procedure was technically successful in all patients. No procedure-related complication was encountered during the in-hospital stay, while none of the patients died. The median hospital stay was 22 days (range 12-46). During a follow-up period spanning an average of 27 months (range 6-44 months) there was one stent-graft thrombosis at 12 months in an otherwise asymptomatic patient that required no further intervention.
  
  
  CONCLUSIONS
  Endovascular technique seems to constitute a reliable approach for treating blunt axillo-subclavian arterial injuries in the emergent setting. Despite uncertainties in patient selection and optimal management algorithms, it seems that endovascular approach could be the first line treatment for such injuries. Accumulation of data on larger number of patients with longer follow-up is warranted to further define the value of this therapeutic modality in the trauma setting.
authors.affiliation: Department of Surgery - Vascular Surgery Unit, School of Medicine, University of Ioannina, Ioannina, Greece. Electronic address: mimats@cc.uoi.gr.
authors.forename: Miltiadis
authors.initials: M
authors.lastname: Matsagkas
authors.affiliation: Department of Surgery - Vascular Surgery Unit, School of Medicine, University of Ioannina, Ioannina, Greece.
authors.forename: George
authors.initials: G
authors.lastname: Kouvelos
authors.affiliation: Department of Surgery - Vascular Surgery Unit, School of Medicine, University of Ioannina, Ioannina, Greece.
authors.forename: Michalis
authors.initials: M
authors.lastname: Peroulis
authors.affiliation: Department of Surgery - Vascular Surgery Unit, School of Medicine, University of Ioannina, Ioannina, Greece.
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Xanthopoulos
authors.affiliation: Department of Surgery - Vascular Surgery Unit, School of Medicine, University of Ioannina, Ioannina, Greece.
authors.forename: Vasilios
authors.initials: V
authors.lastname: Bouris
authors.affiliation: Department of Anesthesiology, School of Medicine, University of Ioannina, Ioannina, Greece.
authors.forename: Eleni
authors.initials: E
authors.lastname: Arnaoutoglou
mesh_terms: D000328:Adult; D000368:Aged; D001366:Axillary Artery / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation; D002404:Catheterization / Q000379:methods; D000072226:Computed Tomography Angiography; D004635:Emergency Medicine; D057510:Endovascular Procedures / Q000379:methods; D017052:Hospital Mortality; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013348:Subclavian Artery / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D016896:Treatment Outcome; D057772:Vascular System Injuries / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D014949:Wounds, Nonpenetrating / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*
keywords: Axillary artery; Endovascular; Injury; Subclavian artery; Trauma