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Subclavian-Brachial Bypass for Chronic Limb Threatening Ischemia Associated with an Old Motorcycle Accident.

Authors:
Jose I Martínez-Quesada Javier E Anaya-Ayala Santiago Mier Y Terán-Ellis Montserrat Miranda-Ramírez Luis H Arzola Christopher Ruben-Castillo Juan C Aramburo Jesus M de Los Ríos Carlos A Hinojosa

Vasc Specialist Int 2022 Jun 17;38:14. Epub 2022 Jun 17.

Department of Surgery, Division of Vascular Surgery and Endovascular Therapy, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubirán, México City, México.

Chronic limb-threatening ischemia is rarely associated with previous traumatic injury. We present a case of a 28-year-old male with progressive digit ulcers, a weak pulse, cyanosis, and a cold limb. Eight months prior, he had a motorcycle accident resulting in a right clavicle fracture and brachial plexus injury. Computed tomography angiography revealed occlusion of the right subclavian artery near a surgically implanted reduction plate. The patient underwent an open subclavian-brachial bypass with a reversed saphenous vein graft. His postoperative recovery was uneventful. After 3 months, he had a euthermic right hand with a palpable pulse and his ulcers had completely healed. This case reinforces the need for patients with a neurological deficit in the upper extremity caused by blunt trauma to undergo thorough vascular examination to identify potential arterial injury and compromised perfusion.

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http://dx.doi.org/10.5758/vsi.220012DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9204331PMC
June 2022

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Injury 2022 Jul 23. Epub 2022 Jul 23.

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Department of Industrial Engineering, University of Florence, 50139 Firenze, Italy.

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- Irmandade da Santa Casa de Misericórdia de São Paulo, Cirurgia - São Paulo - SP - Brasil.

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