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Nonpenetrating Subclavian Artery Injuries
Gerald B. Zelenock, MD;
Andris Kazmers, MD;
Linda M. Graham, MD;
Errol E. Erlandson, MD;
Jack L. Cronenwett, MD;
Walter M. Whitehouse, Jr, MD;
Thomas W. Wakefield, MD;
S. Martin Lindenauer, MD;
James C. Stanley, MD
Arch Surg. 1985;120(6):685-692.
Abstract
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• Nonpenetrating subclavian artery trauma, a potentially catastrophic injury, has been recognized more frequently with the liberal use of angiography in evaluating blunt cervicothoracic trauma. Six patients, five men and one woman, recently underwent surgical treatment at the University of Michigan Hospital for blunt injury of the subclavian artery. The diagnoses were established by arteriography. Physical findings, chest roentgenograms, and results of noninvasive vascular evaluation were found to be nonspecific or unreliable. Operative treatment with resection of the injured arterial segments and either primary anastomosis or bypass grafting resulted in restoration of distal, upper extremity blood flow in all of the cases. One patient died 20 days after trauma from a severe associated cerebral injury. Among the five survivors, residual soft tissue and neurologic injury compromised full recovery in three. Thus, only two of the six patients survived without sequelae, a fact that underscores the seriousness of this type of subclavian artery injury.
(Arch Surg 1985;120:685-692)
Author Affiliations
From the Division of Peripheral Vascular Surgery, University of Michigan Medical Center, Ann Arbor.
Footnotes
Accepted for publication Jan 28, 1985.
Read before the 92nd annual meeting of the Western Surgical Association, Colorado Springs, Colo, Nov 13, 1984.
Reprint requests to University Hospital, 1405 E Ann St, Ann Arbor, MI 48109 (Dr Zelenock).
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