Journal of vascular surgery
-
Comparative Study
Feasibility of endovascular repair in penetrating axillosubclavian injuries: a retrospective review.
Penetrating injuries to the axillary and subclavian vessels are a source of significant morbidity and mortality. Although the endovascular repair of such injuries has been increasingly described, an algorithm for endovascular versus conventional surgical repair has yet to be clearly defined. On the basis of institutional endovascular experience treating vascular injuries in other anatomic locations, we defined an algorithm for the management of axillosubclavian vascular injuries. Subsequently, a near decade long experience with the management of axillosubclavian vascular injuries was retrospectively analyzed, so as to more accurately assess the true feasibility of endovascular treatment in these patients. ⋯ Despite growing enthusiasm for endovascular repair of injuries to the axillary and subclavian vessels, realistic clinical presentation and anatomic locations restrict the broad application of this technique at present. In our experience, less than but approaching 50% of all injuries encountered could be addressed with an endovascular approach. This percentage will increase during the upcoming decades if the endovascular technologies available in hybrid endovascular operating rooms uniformly improve.