Journal of Vascular Surgery
Volume 38, Issue 3 , Pages 451-454, September 2003

Covered stents for injuries of subclavian and axillary arteries☆

Presented at the Twenty-seventh Annual Meeting of the Southern Association for Vascular Surgery, Tucson, Ariz, Jan 15-18, 2003.

  • Eleftherios S Xenos, MD

      Affiliations

    • Department of Surgery, University of Tennessee, Knoxville, Tenn, USA
    • Corresponding Author InformationReprint requests: Eleftherios S. Xenos, MD, University of Tennessee, USA,Department of Surgery, 1924 Alcoa Hwy, Knoxville, TN, USA 37920-6999
    • ,
  • Michael Freeman, MD

      Affiliations

    • Department of Surgery, University of Tennessee, Knoxville, Tenn, USA
    • ,
  • Scott Stevens, MD

      Affiliations

    • Department of Surgery, University of Tennessee, Knoxville, Tenn, USA
    • ,
  • David Cassada, MD

      Affiliations

    • Department of Surgery, University of Tennessee, Knoxville, Tenn, USA
    • ,
  • John Pacanowski, MD

      Affiliations

    • Department of Surgery, University of Tennessee, Knoxville, Tenn, USA
    • ,
  • Mitchell Goldman, MD

      Affiliations

    • Department of Surgery, University of Tennessee, Knoxville, Tenn, USA

Received 17 February 2003; accepted 31 March 2003.

Abstract 

Introduction

Injury to the subclavian and axillary arteries is uncommon. Exposure of these vessels is associated with significant morbidity, and mortality ranges from 5% to 30%. Endovascular methods may offer an alternative approach to these technically challenging injuries.

Methods

We retrospectively studied patients with blunt or penetrating (including iatrogenic) injuries to the subclavian or axillary artery between January 1, 1996 and July 30, 2002. Demographic data, mechanism of injury, concomitant injuries, angiographic findings, and treatment method and outcome were recorded.

Results

Twenty-seven patients with injury to the subclavian or axillary artery were seen at our institution during the study. Twenty-three patients underwent interventions. Eleven patients required open repair; 12 patients had lesions amenable to endovascular repair. Depending on the preference of the surgeon, 5 patients with injuries amenable to endovascular repair underwent open repair, and 7 underwent endovascular repair. A Wallgraft endoprosthesis was used in all patients; two grafts were required in 1 patient. Endovascular repair was associated with shorter operative time (P = .04) and less blood loss (P = .01). One-year patency was similar between the two groups.

Conclusion

Covered stents are a feasible alternative to open repair in properly selected patients with subclavian or axillary artery injury, resulting in shorter procedure time and less blood loss.

 

☆ Competition of interest: none.

PII: S0741-5214(03)00553-6

doi:10.1016/S0741-5214(03)00553-6

Journal of Vascular Surgery
Volume 38, Issue 3 , Pages 451-454, September 2003

Article Tools