Civilian penetrating axillary artery injuries

Abstract

Background: The surgical management and outcome of penetrating axillary artery (AA) injuries is presented.

Patients and methods: Patients presenting to Groote Schuur Hospital with penetrating AA injuries from January 2003 to December 2009 were reviewed. Demographic data, mechanism of injury, associated injuries, angiographic findings, surgical treatment, complications, and mortality were noted.

Results: Sixty-eight patients with AA injuries were identified from an operating trauma database. Stab and gunshot wounds accounted for 54 (79.4%) and 14 injuries, respectively. The mean Revised Trauma Score was 7.5 (range: 3.8-7.8). Angiography was done in 49 patients; false aneurysms (32) and total occlusions (15) were the two commonest findings. Primary repair of the injured AA was possible in 41 (60.3%) patients. Five AA (7.4%) injuries were ligated. Morbidity was restricted to associated brachial plexus injuries. The limb salvage rate was 100%.

Conclusions: Primary repair of AA injuries was possible in 60% of patients, and ligation was life-saving in critically ill patients. The associated brachial plexus injury was the cause of major long-term morbidity.