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Crutch-induced axillary artery injury
D R Feldman1, I Vujic, D McKay
1Department of Radiology, Medical University of South Carolina, Charleston 29425, USA.
Purpose:
To describe the spectrum of radiologic findings in crutch-induced axillary artery injury and the effects of its unique pathophysiology on diagnostic evaluation and treatment.
Methods:
Three patients with axillary crutch-induced axillobrachial injury were studied angiographically and percutaneous intervention was performed in two cases.
Results:
One patient required surgical bypass of a thrombosed axillary artery aneurysm. One patient responded to percutaneous transluminal angioplasty (PTA) of a focal axillary artery stenosis. One patient with an axillary artery aneurysm and distal thromboembolic disease was treated by both thrombolysis and surgical thromboembolectomy and later by PTA of an axillary artery intimal disruption.
Conclusion:
Chronic axillary crutch use may be associated with axillary artery stenosis, aneurysm formation, and secondary axillobrachial thromboembolic disease. Mural injury can be successfully treated by PTA and thromboembolic disease by thrombolytic therapy. Early identification of the axillary artery lesion is critical for long-term therapeutic results.