Damage control for subclavian artery injury.

Area of Science:

• Vascular Surgery
• Trauma Surgery
• Emergency Medicine

Background:

• Penetrating trauma to subclavian vessels carries high mortality, up to 60% pre-hospital and 5-30% in the operating room.
• Injuries to the subclavian artery origin pose significant surgical challenges due to anatomical location and potential for massive hemorrhage.

Purpose of the Study:

• To present a case utilizing damage control principles for a left subclavian artery origin injury.
• To evaluate the efficacy of subclavian ligation as a damage control strategy.
• To review current surgical approaches and treatment paradigms for subclavian vessel injuries.

Main Methods:

• A case report detailing the management of a patient with penetrating left subclavian artery origin injury.
• Application of subclavian ligation as a damage control intervention.
• Review of existing literature on surgical management and damage control strategies for subclavian vessel trauma.

Main Results:

• Successful limb viability of the left upper extremity was maintained post-ligation through collateral circulation.
• The damage control strategy involving subclavian ligation obviated the need for further complex interventions in this case.
• The patient's outcome highlights the potential of targeted damage control in managing severe subclavian vessel injuries.

Conclusions:

• Subclavian ligation can be an effective damage control measure for injuries at the origin of the left subclavian artery.
• Preservation of upper limb viability is achievable via collateral circulation following subclavian ligation in selected trauma cases.
• Damage control principles are crucial for optimizing outcomes in patients with high-risk subclavian vessel trauma.