This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citing articles on HighWire  • Citing articles on Web of Science (34)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Social Bookmarking   What's this?

A Surgical Challenge

John V. Robbs, ChM, FRCS; Lynne W. Baker, MSc, FRCS; Randolph R. Human, FCS(SA); Ismael S. Vawda, FRCS; Harold Duncan, FRCS; P. Rajaruthnam, FRCS

Arch Surg. 1981;116(5):663-668.

Abstract
• The initial clinical observations and methods and results of treatment in 104 patients with subclavian (48), vertebral (four), and carotid (52) artery injuries are reported. Delayed hemorrhage ten days after misdiagnosed subclavian artery injuries resulted in false aneurysms causing compressive brachial plexus palsies. A conservative approach to penetrating cervicomediastinal wounds was adopted with selective use of arch aortography when arterial injury was suspected by defined criteria. This proved safe, accurate, and invaluable for planning operative approach. Partial median sternotomy without entering the pleura proved optimal for superior mediastinal access; simple clavicle transection provided adequate distal subclavian exposure. External carotid and vertebral arteries were ligated. No shunts were employed for common and internal carotid repair. None of the 14 patients revascularized in the presence of a neurologic deficit died and none was made worse by carotid reconstruction.

(Arch Surg 1981;116:663-668)

Author Affiliations
From the Department of Surgery, University of Natal, Durban, South Africa.

Footnotes
Accepted for publication Feb 3, 1981.

Read before the 88th annual meeting of the Western Surgical Association, Salt Lake City, Nov 18, 1980.

Reprint requests to Department of Surgery, University of Natal, PO Box 17039, Congella 4013, South Africa (Dr Robbs).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

DISRUPTION OF THE AORTIC ARCH CONVEXITY CONTAINING THE INNOMINATE AND LEFT COMMON CAROTID ARTERY ORIGINS RESULTING FROM BLUNT TRAUMA
Kalangos et al.
J. Thorac. Cardiovasc. Surg. 1997;114:129-131.
FULL TEXT  

Nonpenetrating Subclavian Artery Injuries
Zelenock et al.
Arch Surg 1985;120:685-692.
ABSTRACT