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Related Experiment Video

Updated: Oct 22, 2025

Transaxillary First Rib Resection for Treatment of the Thoracic Outlet Syndrome
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Vascular damage control at the thoracic outlet.

M P McMonagle1, B Sarani2, J Jenoff3

  • 1St Mary's Hospital, London, UK.

Annals of the Royal College of Surgeons of England
|August 31, 2021
PubMed
Summary
This summary is machine-generated.

Rapid control of subclavian artery injuries, often fatal, can be achieved using temporary intravascular shunts. This damage control technique temporizes bleeding and restores perfusion until definitive repair is possible.

Keywords:
Damage controlMedian sternotomySubclavian arteryVascular shuntVascular trauma

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Area of Science:

  • Vascular Surgery
  • Trauma Surgery
  • Emergency Medicine

Background:

  • Penetrating subclavian artery injuries are associated with high mortality, particularly in patients presenting with shock.
  • The thoracic outlet's anatomical location complicates hemorrhage control.
  • Traditional vessel ligation can lead to delayed intervention, metabolic exhaustion, and limb ischemia.

Observation:

  • A case of a gunshot wound leading to penetrating injury of the subclavian artery is presented.
  • The patient presented in shock, necessitating urgent intervention.
  • Damage control principles were applied to manage the acute hemorrhage.

Findings:

  • Rapid proximal control of the subclavian artery was achieved through the chest.
  • Temporary intravascular shunting was employed to manage blood loss and maintain perfusion.
  • This damage control strategy allowed for physiological optimization prior to definitive vascular repair.

Implications:

  • Temporary intravascular shunting represents a key damage control technique for severe subclavian artery injuries.
  • This approach facilitates temporization of hemorrhage and perfusion restoration, enabling delayed definitive repair.
  • Effective damage control in vascular trauma can significantly improve patient survival and limb salvage rates.