The Turkish Journal of Vascular Surgery
Yazarlar: Abdurrahim ÇOLAK, Uğur KAYA
Konular:-
Anahtar Kelimeler:Brachial artery; arm injuries; upper extremity
Özet: Objective: Arterial injuries of upper extremity may cause important functional defects, limb loss or death. Treatment necessitates an emergent resuscitation, early vascular surgery and repair of the injuries. Upper limb vascular injuries may arise due to several reasons, and may cause important functional defects and extremity loss. In this paper, we aimed to retrospectively analyze and present our patients with upper limb vascular injuries. Material and Methods We retrospectively analyzed 126 patients that admitted to our clinic between March 1998 and August 2013. They had surgery due to upper limb injury in this period. There were 118 (93%) males and 18 (7%) females, and the mean age was 21.4 ± 14.3 years. The etiology was stab wounds in 86 (68%), gunshot wounds in 15 (12%), blunt trauma in 7 (5%), work accident in 6 (5%), vehicle or non-vehicle traffic accidents in 5 (4%), falling from heights in 3 (2%), earthquake in 1 (<1%), burn in 1 (<1%), and surgical trauma in 1 (<1%) patient. The mean duration of ischemia was 9.6 hours, and the mean MESS score was 6.1. Results: Interposition vein graft was the most frequently used method performed in 53 cases. Second most frequent method was primary anastomosis performed in 50 patients. Primary lateral reconstruction done in 50 cases, ligation was done in 5 cases, and interposition with synthetic vascular graft was done in one patient. Due to the close relationship of the vessels with neighborings, subclavian and axillary injuries are usually seen together with neurogenic, soft tissue and osseous injuries. Therefore, functional defects and amputation rates of subclavian and axillary injuries are high when compared to distal injuries. Conclusion: Because subclavian and axillary injuries are frequently associated with neurogenic, soft tissue, and osseous injuries due to vascular structures adjacent to other structures, loss of function and amputation rate are greater than with distal injuries, and early intervention is important in these injuries.