Treatment of major artery injuries in the arm: report of 42 cases

Objective To explore a better treatment strategy for major artery injuries in the arm. Methods Forty-two cases of major artery injuries in the arm were retrospectively analyzed. Among these one patient developed arterovenous fistula following injury to the left subclavian artery, which was treated by interventional blockage. Surgical exploration was carried out in the rest 41 patients. Results Among the surgically treated patients, 37 (90.2%) regained distal blood supply postoperatively. However complete revascularization was seen only in 25 of them (61.0%). The other 12 patients (29.2%) had partial vascular pateney. There were a total of 14 patients who received Fogarty balloon catheter thrombectomy. Among them, 12 patients (85.7 %) regained complete vascnlar patency. Thirteen out of twenty-seven patients (48.1%) who received conventional surgery regained complete blood flow. The difference between the thrombectomy group and the conventional surgery group was statistically significant (P<0.05). Conclusion Collateral circulation develops well when major arteries in the arm were damaged. As a result, the ischernic symptoms of the distal extremity were usually unapparent. Thus in order to avoid re-occlusion caused by residual thrombus, thrombectomy of distal arteries should be applied as a routine revascularization procedure to those patients. If too many vessels have been removed, autolngous or artificial vessels should be grafted. Anticoagulatives should be given after the operation. Key words: Arteries;  Wounds and injuries;  Vascular surgical procedures;  Fogarty balloon catheter