Upper extremity arterial injuries: Experience at the Royal Adelaide Hospital, 1969 to 1991

Fitridge, Robert; Raptis, S.; Miller, J. H.; Faris, Irwin

doi:10.1016/0741-5214(94)90231-3

Cited by 58 publications

(33 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…However, it is recognised that significant injury to the brachial plexus is an indication of poor limb related outcomes 4 and indeed in this case, the patient was ultimately found, once extubated, to have a significant plexus injury with associated arm paralysis and complex pain. Eventually, in these types of cases upper limb amputation rates ultimately approach 30%.…”

Section: Discussionmentioning

confidence: 80%

A Novel Combined Hybrid Approach to Enable Revascularisation of a Trauma-Induced Subclavian Artery Injury

Sabbagh

Chowdhury

Durrani

et al. 2016

EJVES Short Reports

View full text Add to dashboard Cite

IntroductionThis case highlights the complexity of upper limb revascularization after a subclavian artery traumatic injury and strengthens the role of a hybrid/multi-disciplinary approach to such injuries.ReportA 45-year-old male patient presented with an acute right upper limb following a traumatic injury to the right subclavian artery due to a motor vehicle accident (MVA). Associated injuries included an unstable cervical spine injury, a large open right clavicular injury, and a brain injury, which limited the potential revascularisation options available. The arm was revascularised using a hybrid endovascular/open surgical approach, namely embolization of the proximal subclavian artery (just distal to vertebral artery) and a right common femoral artery to distal axillary artery bypass using prosthetic material.DiscussionBlunt injuries to the subclavian artery are often high impact, complex and associated with multiple injuries to surrounding structures, which limit the role of standard procedures used in the elective setting. This case highlights the role of multidisciplinary team involvement, using a hybrid approach and a novel distal inflow site to restore upper limb perfusion.

show abstract

Section: Discussionmentioning

confidence: 80%

A Novel Combined Hybrid Approach to Enable Revascularisation of a Trauma-Induced Subclavian Artery Injury

Sabbagh

Chowdhury

Durrani

et al. 2016

EJVES Short Reports

View full text Add to dashboard Cite

show abstract

“…Inclusion criteria were (1) a single vessel injury at the volar forearm with a well-perfused distal limb on presentation, (2) no evidence of hemodynamic instability as measured by consistent systolic blood pressure measurements above 90 mm Hg, and (3) hemostasis achieved within 15 minutes of initiation of manual pressure dressing. Exclusion criteria were (1) a 2-vessel injury, (2) injuries elsewhere in the body that necessitated a trip to the OR within 6 hours of presentation, and (3) follow-up of less than 1 year.…”

Section: Methodsmentioning

confidence: 99%

Timing of Forearm Arterial Repair in the Well-perfused Limb

Park¹,

Gans²,

Lin³

et al. 2014

Orthopedics

View full text Add to dashboard Cite

The purpose of this study was to evaluate the difference in the outcomes of patients with a well-perfused hand who were taken to the operating room (OR) within 6 hours of forearm arterial injury vs patients who were treated in a semiurgent fashion. A review of 201 consecutive patients who were taken to the OR with forearm-level radial or ulnar arterial injury identified 26 patients who had a well-perfused hand at presentation in whom hemostasis was achieved within 15 minutes with manual pressure and no signs of hemodynamic instability. Outcomes of interest included short-version Disabilities of the Arm, Shoulder and Hand (quickDASH) scores and patient-reported cold intolerance. Of the 26 patients, group 1 included 17 patients who were taken to the OR within 6 hours and group 2 included 9 patients who were taken to the OR in a delayed fashion. Minimum follow-up in both groups was 13 months. Average quickDASH score was 24.5 and 14.1 for groups 1 and 2, respectively. Average time spent in the OR was significantly less in group 2 compared with group 1 (1.7 vs 2.8 hours). In the setting of forearm arterial injury with a well-perfused distal limb, there was no difference in functional outcome in patients taken to the OR emergently compared with those who underwent surgery in a delayed manner. With careful evaluation and monitoring, semiurgent operative repair is feasible and may improve certain aspects of patient care and hospital resource use. Outcome measures in this study support semiurgent treatment of these injuries.

show abstract

“…In the upper extremity, the axillary and brachial arteries are frequently injured by penetrating mechanisms; and in the lower extremity, the superficial femoral and popliteal arteries are most affected. [31][32][33] The smaller infrageniculate vessels can also be injured. However, if in isolation, these injuries are associated with lower rates of mortality and morbidity than the larger, more-proximal vessels.…”

Section: Extremity Vesselsmentioning

confidence: 99%