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Blunt brachial arterial injury in pediatric patients

Muhammad-Saad Hafeez1, David M Notrica2, Claudie Sheahan3

  • 1Division of Vascular Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA.

Journal of Vascular Surgery
|June 2, 2025
PubMed

Insights

Blunt brachial arterial injury (BBAI) is common in children and can cause limb complications. Current literature is reviewed to guide the diagnosis and management of BBAI, addressing treatment controversies.

Area of Science:

  • Pediatric vascular surgery
  • Trauma surgery
  • Vascular medicine

Background:

  • Blunt brachial arterial injury (BBAI) is the most frequent vascular trauma in pediatric patients.
  • BBAI can manifest with varied clinical signs based on occlusion severity and collateral circulation.
  • Controversy exists regarding the optimal treatment for a 'pink pulseless hand' following BBAI.

Purpose of the Study:

  • To review the current literature on blunt brachial arterial injury in pediatric patients.
  • To summarize the pathophysiology, clinical presentation, diagnosis, and evaluation of BBAI.
  • To discuss the best management strategies and address treatment controversies for BBAI.

Main Methods:

  • Comprehensive literature review of pediatric blunt brachial arterial injury.
  • Synthesis of information on BBAI pathophysiology, clinical findings, and diagnostic approaches.
  • Analysis of current treatment modalities, including conservative and surgical options.

Main Results:

  • BBAI presents a spectrum of clinical outcomes influenced by injury severity and collateral flow.
  • Management strategies range from non-operative care to surgical revascularization.
  • The optimal approach for specific BBAI presentations, like the pink pulseless hand, remains debated.

Conclusions:

  • Accurate diagnosis and evaluation are crucial for appropriate BBAI management in children.
  • A standardized treatment algorithm for BBAI is needed to address existing controversies.
  • Multidisciplinary collaboration may improve outcomes for pediatric vascular injuries.

Keywords:
Blunt brachial artery injuryBrachial artery repairPediatric traumaPediatric vascular injuryPediatric vascular traumaSupracondylar subluxationUpper extremity fracture

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