Traumatic subclavian and axillary vessel injuries

Abstract

In an analysis of medical records on upper limb vascular trauma over a 9-year period (1989–1997) at Istanbul Faculty of Medicine's Surgical and Medical Emergencies Department, it was found that 28 patients required surgery for subclavian or axillary vessel injuries. Of these, 20 cases (71.4%) were the result of penetrating and 8 cases (28.5%) were the result of blunt injury. Eight patients had an associated brachial plexus lesion. Patients were treated by either primary repair (50%), saphenous vein graft interposition (41.6%), or ligation (14.2%). Overall mortality rate was 14% (four cases). No long-term vascular sequela occurred related to the vascular repair techniques. However, the long-term outcome of brachial plexus lesions was poor in four patients. Therefore, the outcome of upper limb injury is not dependent on the vascular injury which can be successfully managed. The long-term consequences are determined by the associated orthopedic, soft tissue, and nerve injuries.