Document Detail


Analysis of blunt and penetrating injury of the innominate and subclavian arteries.
MedLine Citation:
PMID:  8304648     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Injury to the innominate or subclavian artery is an uncommon but difficult management problem. Review of trauma admissions from August 1983 to August 1992 revealed 21 patients who sustained injury to the innominate or subclavian artery. Eight patients sustained blunt trauma, while 13 patients sustained penetrating injuries. The mechanism of injury was variable, and associated injuries were common in both blunt and penetrating trauma. Injuries involved the right innominate or subclavian artery in 10 patients and the left subclavian artery in 11 patients. Twenty patients were managed operatively. Primary repair was preferred for penetrating injuries, whereas a bypass graft was more common for blunt injuries (P = 0.41). Patients with penetrating injury were more unstable at presentation (admission systolic blood pressure 73 mm Hg vs 119 mm Hg, P = 0.006; preoperative evaluation time 66 min vs 319 min, P = 0.002) and required more blood transfusions (5 units vs 26 units, P = 0.007) than patients with blunt injuries. Mortality for the entire series was 24 per cent (0% blunt vs 38% penetrating, P = 0.047). Hospital days (28 vs 48) and ICU days (8 vs 14) were longer for survivors of penetrating injuries (P = NS). Complications were common in both groups. Innominate/subclavian artery injury remains a significant cause of mortality and morbidity.
Authors:
S J Hoff; M K Reilly; W H Merrill; J Stewart; W H Frist; J A Morris
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The American surgeon     Volume:  60     ISSN:  0003-1348     ISO Abbreviation:  Am Surg     Publication Date:  1994 Feb 
Date Detail:
Created Date:  1994-03-07     Completed Date:  1994-03-07     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0370522     Medline TA:  Am Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  151-4     Citation Subset:  IM    
Affiliation:
Department of Surgery, Vanderbilt University School of Medicine, Nashville, Tennessee.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Brachiocephalic Trunk / injuries*,  surgery
Child
Female
Humans
Male
Middle Aged
Postoperative Complications
Subclavian Artery / injuries*,  surgery
Wounds, Nonpenetrating* / diagnosis,  mortality,  surgery
Wounds, Penetrating* / diagnosis,  mortality,  surgery

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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