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Subclavian vascular injuries.

D Demetriades1, B Rabinowitz, A Pezikis

  • 1Department of Surgery, University of the Witwatersrand Medical School, Johannesburg, South Africa.

The British Journal of Surgery
|November 1, 1987
PubMed
Summary
This summary is machine-generated.

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Penetrating injuries to subclavian vessels have high mortality, especially venous injuries due to air embolism. Physical examination is sufficient for diagnosis, guiding a selective conservative treatment approach.

Area of Science:

  • Vascular Surgery
  • Trauma Care
  • Emergency Medicine

Background:

  • Penetrating trauma to the subclavian vessels presents a significant challenge in emergency medicine.
  • High mortality rates are associated with injuries to these major thoracic vessels.

Purpose of the Study:

  • To analyze the outcomes of penetrating injuries to the subclavian vein and artery.
  • To evaluate diagnostic methods and treatment strategies for these injuries.

Main Methods:

  • Retrospective analysis of 228 patients with penetrating subclavian vessel injuries.
  • Review of injury patterns, diagnostic approaches, surgical interventions, and mortality rates.

Main Results:

  • Overall mortality was 66%, with 61% of patients not surviving to hospital admission.

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  • Venous injuries had higher mortality (P < 0.01) than arterial injuries, likely due to air embolism.
  • Physical examination was deemed reliable for diagnosis, negating the need for emergency angiography.

    • Conclusions:

    • A selective conservative approach is recommended for subclavian vessel injuries.
    • Prompt diagnosis via physical examination and appropriate surgical or non-surgical management are crucial for improving outcomes.