Isolated axillary artery injury due to blunt trauma

Department of Thoracic and Cardiovascular Surgery, Hacettepe University, Faculty of Medicine, Ankara, Turkey.
Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery: TJTES (Impact Factor: 0.38). 05/2007; 13(2):145-8.
Source: PubMed


The intimal damage of the axillary artery due to an acute, single blunt trauma is very rare without concomitant bone, brachial plexus, venous and soft tissue injuries. Early diagnosis and appropriate management of the arterial injury is essential to avoid permanent disability. The clinical signs are usually occult and do not become manifest until a long ischemic interval following injury, owing to the extensive collateral network. A twenty-year-old male patient had injured his left arm in a hyperabduction and hyperextension position while he was carrying a refrigerator with his arm. An increase in the intensity of pain and numbness reappeared in his left arm 1.5 months after the trauma. Digital subtraction angiography of the axillary artery performed after his hospitalization showed an occlusion of the axillary artery and no reconstitution of distal part of the occlusion via collateral vessels. During the operation, the axillary and brachial arteries were bypassed with a saphenous graft. As shown in this case report, in the early period after blunt trauma of the upper limb, progressive signs of vascular compromise may disappear because of collateral circulation even if the distal pulses are absent. Then an angiography of the upper limb becomes essential for correct diagnosis and treatment. This is our second experience. On the basis of our first experience that was reported, in such a chronic case, oral anticoagulation must be carried out at least six months whenever a graft thrombosis after revascularization is encountered.

Download full-text


Available from: Halil Ibrahim Ucar, Sep 29, 2015
19 Reads
  • Source
    • "Injuries of the axillary artery are not common [1] [2] and fractures of the upper end of the humerus/humerus neck are rarely associated with injuries of the axillary artery [3] [4], probably due to the abundance of loose connective tissue and soft tissue space in the axilla along with absence of tight compartments. Fractures of the distal one-third of the humerus in contrast to the proximal humerus are commonly associated with brachial artery injury and radial nerve injuries because of tight compartments and close proximity of the neurovascular bundle with the humerus. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Proximal humerus fractures are rarely associated with axillary artery injury. We present a case of a 59-year-old female who had fracture neck humerus along with absent pulsations in the left upper limb after blunt trauma. Computed tomographic angiogram revealed complete occlusion of the left axillary artery. Urgent surgical intervention was done in the form of fixation of fracture followed by exploration and repair of axillary artery. Axillary artery was contused and totally occluded by fractured edge of humerus. Repair of the axillary artery was done using basilic vein graft harvested through the same incision. Postprocedure pulsations were present in the upper limb.
    06/2014; 2014:430583. DOI:10.1155/2014/430583
  • [Show abstract] [Hide abstract]
    ABSTRACT: We describe a case of innovative endovascular techniques to repair traumatic bilateral axillary artery disruption. A 36-year-old male construction worker fell eight stories from a scaffold and sustained bilateral axillary artery injuries. The injuries between the brachial and axillary arteries were bridged using long bare self-expanding stents (Zilver). To the best of our knowledge, this is a novel case report from a level-one trauma center where endovascular techniques were employed to repair bilateral axillary arteries with long-term follow-up.
    Annals of Vascular Surgery 02/2010; 24(4):551.e5-8. DOI:10.1016/j.avsg.2009.08.017 · 1.17 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Nous rapportons un cas de technique endovasculaire innovante utilisée pour la réparation d’une rupture traumatique bilatérale de l’artère axillaire. Un patient de 36 ans travaillant dans le Bbtiment fit une chute d’un échafaudage d’une hauteur de huit étages et présentait des lésions traumatiques bilatérales des artères axillaires. La continuité entre les artères brachiales et axillaires était rétablie en utilisant de longs stents nus auto expansibles (Zilver). A notre connaissance, il s’agit d’un cas original d’utilisation des techniques endovasculaires dans un trauma center de niveau 1 pour le traitement de lésions traumatiques bilatérales des artères axillaires, avec un suivi à long terme.
    Annales de Chirurgie Vasculaire 05/2010; 24(4). DOI:10.1016/j.acvfr.2010.12.031
Show more