Brachial artery injury management: Case series

Abstract

We performed this retrospective study to analyze our strategies for managing and surgically treating brachial artery injuries. Twenty patients with traumatic brachial artery injuries underwent surgery at our institution, from May 2013 to January 2016. Fifteen patients were male, and five were female (age range, 20-45 years; mean, 30 years). Twelve of the patients had penetrating injuries (two had stab wounds; two had window glass injuries; and eight had industrial accidents); eight had blunt trauma injuries (traffic accidents). Five patients had a peripheral nerve injury. All patients underwent Doppler ultrasonographic examination. The repair involved end-to-end anastomosis for eight injuries, reverse saphenous vein graft interpositional grafts for eight, and primary repair for four. Venous continuity was achieved in 8 of 12 patients who had major venous injuries. Nine of the twenty patients required primary fasciotomy. Follow-up showed that two of the five patients with peripheral nerve injury had apparent disabilities due to nerve injury. There were no deaths. Good results can be achieved in patients with brachial artery injuries by use of careful physical examination, Doppler ultrasonography, and vascular repair and debridement of nonviable tissues. Traumatic neurologic injury addressed expediently with nerve grafting may reduce the subsequent disability.

Keywords

• Brachial artery injury/complications/diagnosis/surgery
• computed tomography angiography
• peripheral nerves injuries
• saphenous vein
• thrombosis/etiology