Skip to main content

Advertisement

SpringerLink
Log in

Traumatic Injuries to the Subclavian and Axillary Arteries: A 13-Year Review

  • Published:
Surgery Today Aims and scope Submit manuscript

Abstract

Purpose

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.

Conclusion

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. NM Rich RW Hobson BS Jarstfer TM Geer (1973) ArticleTitleSubclavian artery trauma J Trauma 13 485–96 Occurrence Handle1:STN:280:CSyC1MnosVE%3D Occurrence Handle4711281

    CAS  PubMed  Google Scholar 

  2. E Degiannis G Velmahos D Krawczykowski RD Levy I Souter R Saadia (1994) ArticleTitlePenetrating injuries of the subclavian vessels Br J Surg 81 524–6 Occurrence Handle1:STN:280:ByuB28rgtlE%3D Occurrence Handle8205425

    CAS  PubMed  Google Scholar 

  3. SM George SuffixJr MA Croce TC Fabian EC Mangiate KA Kudsk GR Voeller et al. (1991) ArticleTitleCervicothoracic arterial injuries: recommendations for diagnosis and management World J Surg 15 134–40 Occurrence Handle10.1007/BF01658986 Occurrence Handle1994597

    Article  PubMed  Google Scholar 

  4. JW Pate FH Cole WA Walker TC Fabian (1993) ArticleTitlePenetrating injuries of the aortic arch and its branches Ann Thorac Surg 55 586–92 Occurrence Handle1:STN:280:ByyC1MbjvVQ%3D Occurrence Handle8452417

    CAS  PubMed  Google Scholar 

  5. R Pretre P Hoffmeyer M Bednarkiewicz K Kursteiner B Faidutti (1994) ArticleTitleBlunt injury to the subclavian or axillary artery J Am Coll Surg 179 295–8 Occurrence Handle1:STN:280:ByuA2cfmsVM%3D Occurrence Handle8069425

    CAS  PubMed  Google Scholar 

  6. SJ Hoff MK Reilly WH Merrill J Stewart WH Frist JA Morris SuffixJr (1994) ArticleTitleAnalysis of blunt and penetrating injury of the innominate and subclavian arteries Am Surg 60 151–4 Occurrence Handle1:STN:280:ByuC3snotlE%3D Occurrence Handle8304648

    CAS  PubMed  Google Scholar 

  7. RA Fitridge S Raptis JH Miller I Faris (1994) ArticleTitleUpper extremity arterial injuries: experience at the Royal Adelaide Hospital, 1969–1971 J Vasc Surg 20 941–6 Occurrence Handle1:STN:280:ByqD1c3gslA%3D Occurrence Handle7990189

    CAS  PubMed  Google Scholar 

  8. MC Costa JV Robbs (1988) ArticleTitleNonpenetrating subclavian artery trauma J Vasc Surg 8 71–5 Occurrence Handle10.1067/mva.1988.avs0080071 Occurrence Handle1:STN:280:BieB2MbktlY%3D Occurrence Handle3385881

    Article  CAS  PubMed  Google Scholar 

  9. JT Strum JS Dorsey FR Olson JF Perry (1984) ArticleTitleThe management of subclavian artery injuries following blunt thoracic trauma J Vasc Surg 38 188–91

    Google Scholar 

  10. KR Borman WH Snyder JA Weigelt (1984) ArticleTitleCivilian arterial trauma of the upper extremity: an 11-year experience in 267 patients Am J Surg 148 796–9 Occurrence Handle10.1016/0002-9610(84)90440-9 Occurrence Handle1:STN:280:BiqD2s%2FgsVc%3D Occurrence Handle6507753

    Article  CAS  PubMed  Google Scholar 

  11. JP Meyer D Goldfaden J Barrett T McClean D Spigos JJ Schuler et al. (1988) ArticleTitleSubclavian and innominate artery trauma: a recent experience with nine patients J Cardiovasc Surg 29 283–9 Occurrence Handle1:STN:280:BieB2czovFY%3D

    CAS  Google Scholar 

  12. SF Johnson SB Johnson WE Strodel DE Barker PA Kearney (1991) ArticleTitleBrachial plexus injury: association with subclavian and axillary vascular trauma J Trauma 31 1546–50 Occurrence Handle1:STN:280:By2D2cnit10%3D Occurrence Handle1942180

    CAS  PubMed  Google Scholar 

  13. CE Hyre DF Cikrit SG Lalka AP Sawchuk MC Dalsing (1988) ArticleTitleAggressive management of vascular injuries of the thoracic outlet J Vasc Surg 27 IssueID5 881–4

    Google Scholar 

  14. R Guloglu Y Bilsel H Alis C Ertekin M Kurtoglu (1999) ArticleTitleTraumatic subclavian and axillary vessel injuries Int J Angiogr 8 105–8 Occurrence Handle10.1007/BF01616825

    Article  Google Scholar 

  15. EH Phillips WF Rogers MR Gaspar (1981) ArticleTitleFirst rib fractures: incidence of vascular injury and indications for angiography Surgery 89 42–7 Occurrence Handle1:STN:280:Bi6C38nns1w%3D Occurrence Handle7466610

    CAS  PubMed  Google Scholar 

  16. JD Richardson RB McElvein JF Trinkle (1975) ArticleTitleFirst rib fracture: a hallmark of severe trauma Ann Surg 181 251–4 Occurrence Handle1:STN:280:CSqC28zltlc%3D Occurrence Handle1130843

    CAS  PubMed  Google Scholar 

  17. LT Lim JD Saletta DP Flanigan (1979) ArticleTitleSubclavian and innominate artery trauma Surgery 86 890–7 Occurrence Handle1:STN:280:Bi%2BD1c3gt10%3D Occurrence Handle390753

    CAS  PubMed  Google Scholar 

  18. E Degiannis RD Levy T Potakar R Saadia (1995) ArticleTitlePenetrating injuries of the axillary artery Aust N Z J Surg 5 IssueID65 327–30

    Google Scholar 

  19. JM Bergstein JF Blair J Edwards JB Towne DH Wittmann C Aprahamian et al. (1992) ArticleTitlePitfalls in the use of color-flow duplex ultrasound for screening of suspected arterial injuries in penetrated extremities J Trauma 33 395–402 Occurrence Handle1:STN:280:ByyD387is1c%3D Occurrence Handle1404508

    CAS  PubMed  Google Scholar 

  20. BJ D’Othee H Rousseau P Otal (1999) ArticleTitleNon-covered stent placement in a blunt traumatic injury of the right subclavian artery Cardiovasc Intervent Radiol 22 424–7 Occurrence Handle10.1007/s002709900420 Occurrence Handle10501898

    Article  PubMed  Google Scholar 

  21. DF Dutort DC Strauss M Blaszczyk (2000) ArticleTitleEndovascular treatment of penetrating thoracic outlet arterial injuries Eur J Vasc Endovasc Surg 19 489–95 Occurrence Handle10.1053/ejvs.1999.1050 Occurrence Handle10828229

    Article  PubMed  Google Scholar 

  22. ES Xenos M Freeman S Stevens D Cassada J Pacanowski M Goldman (2003) ArticleTitleCovered stents for injuries of subclavian and axillary arteries J Vasc Surg 38 451–4 Occurrence Handle10.1016/S0741-5214(03)00553-6 Occurrence Handle12947252

    Article  PubMed  Google Scholar 

  23. J Meyer J Walsh J Schuler J Barrett J Durham J Eldrup-Jorgensen et al. (1987) ArticleTitleThe early fate of venous repair after civilian vascular trauma Ann Surg 206 458–64 Occurrence Handle1:STN:280:BieD38zgtFQ%3D Occurrence Handle2959215

    CAS  PubMed  Google Scholar 

  24. D Demetriades S Chahwan H Gomez R Peng G Velmahos J Murray et al. (1999) ArticleTitlePenetrating injuries to the subclavian and axillary vessels J Am Coll Surg 188 290–5 Occurrence Handle10.1016/S1072-7515(98)00289-0 Occurrence Handle1:STN:280:DyaK1M7mtlOjsw%3D%3D Occurrence Handle10065818

    Article  CAS  PubMed  Google Scholar 

  25. D Demetriades B Rabinowitz A Pezikis J Franklin G Palexas (1987) ArticleTitleSubclavian vascular injuries Br J Surg 74 1001–3 Occurrence Handle1:STN:280:BieD2sfoslI%3D Occurrence Handle3690221

    CAS  PubMed  Google Scholar 

  26. HV Schaff RK Brawley (1977) ArticleTitleOperative management of penetrating vascular injuries of the thoracic outlet Surgery 82 182–91 Occurrence Handle1:STN:280:CSiB3MnkslQ%3D Occurrence Handle877862

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of General Surgery, Istanbul Medical Faculty, Istanbul University, Turgut Özal Cad., Çapa, 34310, Istanbul, Turkey

    Murat Aksoy, Fatih Tunca, Hakan Yanar, Recep Guloglu, Cemalettin Ertekin & Mehmet Kurtoglu

Authors
  1. Murat Aksoy
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Fatih Tunca
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Hakan Yanar
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Recep Guloglu
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Cemalettin Ertekin
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Mehmet Kurtoglu
    View author publications

    You can also search for this author in PubMed Google Scholar

Additional information

This work was presented at the 5th European Congress of Trauma and Emergency Surgery. October 1–5, 2002 in Istanbul, Turkey

Rights and permissions

Reprints and permissions

About this article

Cite this article

Aksoy, M., Tunca, F., Yanar, H. et al. Traumatic Injuries to the Subclavian and Axillary Arteries: A 13-Year Review. Surg Today 35, 561–565 (2005). https://doi.org/10.1007/s00595-005-2990-y

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00595-005-2990-y

Key words

Search

Navigation