Subclavian and axillary arterial injuries are uncommon and in the setting of scapulothoracic dissociation present difficulties in diagnosis, assessment, and reconstruction. We present a case of subclavian artery disruption in such a setting, in which palmar duplex identified the need for reperfusion and provided assessment of an extra-anatomic bypass. Palmar arterial duplex may provide a useful tool in select cases of upper extremity arterial trauma.
BrancoBCBoutrousMLDuBoseJJ, et al. Outcome comparison between open and endovascular management of axillosubclavian arterial injuries. Presented at the 2015 Vascular Annual Meeting of the Society for Vascular Surgery, Chicago, Ill, June 17-20, 2015. J Vasc Surg. 2016;63(3):702-709. doi:10.1016/j.jvs.2015.08.117.
2.
DoodyOGivenMFLyonSM.Extremities-Indications and techniques for treatment of extremity vascular injuries. Injury. 2008;39(11):1295-1303. doi:10.1016/j.injury.2008.02.043.
3.
FelicianoD.For the patient—evolution in the management of vascular trauma. J Trauma Acute Care Surg. 2017;83(6):1205-1212. doi:10.1097/TA.0000000000001689.
4.
SommersetJMaryCSeaSTesoDKarmy-JonesR.Arterial duplex as an adjunct to assist decision making in the management of arterial trauma. J Vasc Ultrasound. 2018;43(1):25-29. doi:10.1177/1544316718817423.
5.
FelicianoDVMooreEEWestMA, et al. Western trauma association critical decisions in trauma. J Trauma Acute Care Surg. 2013;75(3):391-397. doi:10.1097/ta.0b013e3182994b48
6.
AssenzaMCentonzeLValesiniLCampanaGCoronaMModiniC.Traumatic subclavian arterial rupture: a case report and review of literature. World J Emerg Surg. 2012;7(1):18. doi:10.1186/1749-7922-7-18.
7.
ShalhubSStarnesBWHatsukamiTSKarmy-JonesRTN. Repair of blunt thoracic outlet arterial injuries: an evolution from open to endovascular approach. J Trauma. 2011;71(5):E114-E121.
8.
D’AlessioIDomaninMBissaccoD, et al. Operative treatment and clinical outcomes in peripheral vascular trauma. The combined experience of two centers in the endovascular era. Ann Vasc Surg. 2020;62:342-348. doi:10.1016/j.avsg.2019.06.037
9.
ChooAMSchottelPCBA. Scapulothoracic dissociation: evaluation and management. J Am Acad Orthop Surg. 2017;25(5):339-347.
