Management of Peripheral Arterial Injuries at Ibadan: Case Report

Adebo, O A; Osinowo, O

doi:10.1177/153857448602000110

Cited by 2 publications

(5 citation statements)

References 5 publications

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“…In our study, most of the patients with traumatic brachial artery injuries had delayed presentation in our setting, thus making delayed arterial revascularization the treatment norm. This was the finding in other centers [ 2 , 5 ]. So, it stands to reason that repair can be effected even beyond the golden hour [ 1 ].…”

Section: Discussionsupporting

confidence: 89%

“…He sustained endothelial injury with associated intra-luminal thrombose formation in the brachial artery for which arteriotomy, embolectomy and lateral repair were done. Stab wounds and blunt trauma were the commonest modes of injury as observed in a study in our country about 3 decades ago [ 2 ]. In another country outside, stab injuries were the commonest while other causes included glass cut injuries, industrial accidents, road traffic crash, gunshots [ 9 , 10 ].…”

Section: Discussionmentioning

confidence: 99%

“…Vascular injuries in the country pose a great deal of distress to patients as a result of dearth of vascular surgeons to deal with the challenge [ 1 ]. This is more often than not, leads to delayed presentations for specialist care [ 2 , 3 ] with a poor outcome. It has been observed that patients with trauma have better outcomes if they are given definitive care within 1 hour of the occurrence of their injuries generally [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

“…The brachial artery is the most frequently injured artery in the upper limb [ 5 , 6 ]. Yet most of the patients present late [ 2 , 3 , 6 ] when surgical intervention would have been thought not to be necessary. The repair of traumatic brachial artery injury beyond the ‘golden hour’ is still recommended [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

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Delayed brachial artery reconstruction after traumatic injury: a case for sustainment of surgical intervention

Okonta¹,

Ocheli²,

Gbeneol³

2017

Pan Afr Med J

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The brachial artery is the commonest artery injured in the extremities. Although the patients present late, nevertheless reconstructions is advocated in other to salvage the limb and maintain function of the hand. We retrospectively examined 25 consecutive patients with vascular injuries treated at The Cardiovascular and Thoracic Surgery Unit of a tertiary health centre over a period of 4 years. We assessed the pre-tertiary methods of stopping of bleeding injured brachial arteries, mechanisms of injury, associated injuries, treatment and the outcome following vascular repair in terms of functionality of the forearm and the volume of the radial pulsation. A total of 12 patients (48.0%) had brachial artery injuries out of the 25 patients with different forms of vascular injuries during the period. There were 10 males and 2 females, aged 7.5-65 years. The aetiology of the brachial artery injuries were: Glass cut in 5 patients, knife cut in 3 patients, surgical complication of tendon release (iatrogenic) in 1 patient, injury from self injection of pentazocine in 1 patient, machete cut in 1 patient and blunt vascular injury from fan belt injury in 1 patient. Except for the young girl whose brachial artery was injured at surgery, and had lateral repair done within 3hours, the timing between injury and repair in the remaining 11 patients ranged between 6-288 hours. This was beyond the golden time in trauma cases. Two patients had the brachial artery revascularised using the Reversed Saphenous Vein Graft (RSVG). The wrist pulsation was small volume in one patient as felt by palpation before discharge though the forearm was viable. Otherwise the remaining patients’ outcome was good. Most of the patients with brachial artery injury present late following injury. Revascularisation beyond the golden hour is still desirable as it will help to prevent limb loss. Plans should be put in place to train vascular surgeon to encourage prompt and expertise care.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Delayed brachial artery reconstruction after traumatic injury: a case for sustainment of surgical intervention

Okonta¹,

Ocheli²,

Gbeneol³

2017

Pan Afr Med J

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“…Similar approach was adopted at other centers. 8,9 In our study, the limb salvage rate was 100%. This could be attributed to rich collateral circulation in the upper limb of most patients.…”

Section: Discussionsupporting

confidence: 44%

Operative management and outcomes of brachial artery revascularization following delayed presentation of traumatic brachial artery injury: surgical persistence rewarded

2021

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Background: Dearth of expertise to manage vascular trauma spiraled with delay in diagnosis and referral to tertiary care centers continue to plague a developing nation like India. The brachial artery is the commonest artery to be injured in extremity following trauma. Although the patients present late, revascularization to salvage the limb and to maintain its function is advocated. This retrospective study was done to evaluate the management and outcomes of brachial artery revascularization in patients with delayed presentation of traumatic brachial artery injury.Methods: Twenty-six patients of traumatic brachial artery injury who met the inclusion criteria during 1-year study period (August 2019 to July 2020) were included. Patients with iatrogenic vascular injury, severe vascular injury associated with massive orthopaedic neuromuscular injury (i.e., crush injury), mottled upper limb and injury to neck, chest, abdomen, lower limbs or any pseudoaneurysm were excluded. Data were analysed.Results: Amongst 26 patients studied, 24 (92.30%) patients had complete transection of the artery. Of these, 19 (79.16%) had primary repair in the form of end-to-end anastomosis and 7 (29.16%) underwent reverse interposition saphenous vein grafting. Two patients with partial laceration of brachial artery underwent primary (lateral) repair. Associated fracture of humerus was managed with internal fixation following revascularization. Four cases underwent end to end repair of median nerve. Majority, 22 (84.61%) had good functional outcome and 4 (15.38%) had satisfactory functional results. Limb salvage rates was 100%.Conclusions: Revascularization beyond warm ischemia time is still desirable to prevent limb loss. Traumatic neurological injury affects the functional outcome.

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Management of Peripheral Arterial Injuries at Ibadan: Case Report

Cited by 2 publications

References 5 publications

Delayed brachial artery reconstruction after traumatic injury: a case for sustainment of surgical intervention

Delayed brachial artery reconstruction after traumatic injury: a case for sustainment of surgical intervention

Operative management and outcomes of brachial artery revascularization following delayed presentation of traumatic brachial artery injury: surgical persistence rewarded

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