Brachial artery injury in a referral center in central Mexico

Abstract

Introduction: Brachial artery lesions are rare, even in high concentration trauma centers and despite having good technical success, they can have significant functional limitations due to being associated with nerve lesions, that is why we decided to describe our experience in the management of lesions of brachial artery. Material and methods: Review of clinical records of patients with brachial artery injury treated by the vascular surgery service at the General Hospital of Mexico from January 1, 2013 to May 30, 2022 was performed. Characteristics of the lesions, time elapsed from lesion to revascularization, type of surgical treatment, and postoperative results. Results: 16 lesions were treated. 100% with late referral (more than 6 hours after the injury). There were 9 (56.25%) complete sections, 4 (25%) partial section, 2 (12.5%) thrombosis, and 1 (6.25%) pseudoaneurysm. 100% of the lesions were distal to the deep brachial branch. 8 (50%) had associated venous injury, 6 (37.5%) nerve injury (median nerve in 100%). The treatment was 3 (18.75%) simple closure by partial section, 3 (18.75%) end-to-end anastomosis, 8 (50%) autologous bypass (5 with reverse vein of the ipsilateral arm and 3 with great saphenous vein) and 2 (12.5 %) thrombectomy. Technical success in 100% and 0% amputation. Conclusion: Due to the important collaterality of the brachial artery, the percentage of amputation is very low and, despite late care, revascularization should be offered to improve the functional prognosis of the limb.

Keywords

• Brachial artery injury. Brachial trauma. Late revascularization.