Endovascular Treatment of a Traumatic Axillary Artery Rupture Using the Dual Bull's-Eye Technique

Area of Science:

• Vascular Surgery
• Interventional Radiology
• Endovascular Techniques

Background:

• Axillary artery rupture is a rare but serious complication, often associated with shoulder dislocations.
• Traditional surgical repair can be challenging due to anatomical location and patient comorbidities.
• Endovascular repair offers a less invasive alternative for managing vascular injuries.

Observation:

• An 83-year-old female patient presented with axillary artery rupture post-shoulder dislocation reduction.
• Initial endovascular attempts using standard antegrade and retrograde approaches were unsuccessful in re-establishing arterial continuity.
• The dual bull's-eye technique was employed, utilizing two snares for precise guidewire manipulation.

Findings:

• A covered self-expandable stent was successfully deployed after guidewire passage through the dual snare system.
• Post-procedure angiography confirmed cessation of hemorrhage and restoration of the radial pulse.
• Nine-month follow-up demonstrated complete patency of the repaired artery without complications.

Implications:

• The dual bull's-eye technique provides a valuable alternative for complex axillary artery ruptures when conventional endovascular methods fail.
• This approach expands the armamentarium for managing challenging vascular injuries in high-risk patients.
• Successful endovascular repair can lead to improved patient outcomes and reduced morbidity compared to open surgery.