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Chen AY, Laniado I, Lin PH. Durability of the Viabahn stent graft after axillary artery pseudoaneurysm exclusion. JOURNAL OF VASCULAR SURGERY CASES INNOVATIONS AND TECHNIQUES 2017; 3:99-101. [PMID: 29349390 PMCID: PMC5757809 DOI: 10.1016/j.jvscit.2016.10.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/23/2016] [Accepted: 10/25/2016] [Indexed: 12/02/2022]
Abstract
Pseudoaneurysm formation caused by iatrogenic arterial injury during a regional anesthetic block is a rare complication. We report a case of a 56-year-old male patient who developed an axillary artery pseudoaneurysm caused by brachial plexus block performed for an upper extremity dialysis access operation. Successful repair of this pseudoaneurysm was achieved with endovascular stent graft exclusion. The repaired axillary artery with the stent graft remained patent after 10 years of follow-up. The successful long-term patency of this treatment and a strategy to potentially avoid this complication are discussed.
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Affiliation(s)
- Aaron Y Chen
- Division of Vascular Surgery and Endovascular Therapy, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Tex
| | - Isaac Laniado
- Division of Vascular Surgery and Endovascular Therapy, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Tex
| | - Peter H Lin
- Division of Vascular Surgery and Endovascular Therapy, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Tex.,University Vascular Associates, Los Angeles, Calif
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Wong VW, Katz RD, Higgins JP. Interpretation of upper extremity arteriography: vascular anatomy and pathology [corrected]. Hand Clin 2015; 31:121-34. [PMID: 25455362 DOI: 10.1016/j.hcl.2014.09.009] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Understanding the utility and interpretation of upper extremity angiography is critical for the hand surgeon treating vaso-occlusive diseases of the hand. Although invasive and requiring the use of contrast dye, it remains the gold standard for imaging of the vascular system of the upper extremity. Angiography may detect numerous variants of the upper limb arterial system which may contribute to surgical pathology. Extensive vascular collateralization helps to maintain perfusion to the hand and facilitates reconstruction of the upper extremity. It is paramount to remember that angiography is a dynamic study and should represent a "flexible roadmap" for surgical reconstruction.
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Affiliation(s)
- Victor W Wong
- Curtis National Hand Center, MedStar Union Memorial Hospital, 3333 North Calvert Street #200, Baltimore, MD 21218, USA
| | - Ryan D Katz
- Curtis National Hand Center, MedStar Union Memorial Hospital, 3333 North Calvert Street #200, Baltimore, MD 21218, USA
| | - James P Higgins
- Curtis National Hand Center, MedStar Union Memorial Hospital, 3333 North Calvert Street #200, Baltimore, MD 21218, USA.
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Mazzini FN, Vu T, Prichayudh S, Sciarretta JD, Chandler J, Lieberman H, Marini C, Asensio JA. Operative exposure and management of axillary vessel injuries. Eur J Trauma Emerg Surg 2011; 37:451. [PMID: 26815415 DOI: 10.1007/s00068-011-0134-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2011] [Accepted: 06/19/2011] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Axillary vessel injuries are uncommon and challenging injuries encountered by trauma surgeons. Proximity of this vessel to other adjacent veins including the axillary vein, brachial plexus and the osseous structures of the shoulder and upper arm account for a large number of associated injuries. MATERIALS AND METHODS Systematic review of the literature, with emphasis on the diagnosis, treatment and outcomes of these injuries, incorporating the authors' experience. CONCLUSIONS Although uncommon, axillary arterial injuries can result in significant morbidity, limb loss and mortality. Early diagnosis and timely repair of the artery leads to good outcomes.
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Affiliation(s)
- F N Mazzini
- Division of Trauma Surgery and Surgical Critical Care, Dewitt-Daughtry Family Department of Surgery, University of Miami Miller School of Medicine, Ryder Trauma Center, 1800 NW 10 Avenue Suite T-247, Miami, FL, 33136-1018, USA
| | - T Vu
- Division of Trauma Surgery and Surgical Critical Care, Dewitt-Daughtry Family Department of Surgery, University of Miami Miller School of Medicine, Ryder Trauma Center, 1800 NW 10 Avenue Suite T-247, Miami, FL, 33136-1018, USA
| | - S Prichayudh
- Division of Trauma Surgery and Surgical Critical Care, Dewitt-Daughtry Family Department of Surgery, University of Miami Miller School of Medicine, Ryder Trauma Center, 1800 NW 10 Avenue Suite T-247, Miami, FL, 33136-1018, USA
| | - J D Sciarretta
- Division of Trauma Surgery and Surgical Critical Care, Dewitt-Daughtry Family Department of Surgery, University of Miami Miller School of Medicine, Ryder Trauma Center, 1800 NW 10 Avenue Suite T-247, Miami, FL, 33136-1018, USA
| | - J Chandler
- Division of Trauma Surgery and Surgical Critical Care, Dewitt-Daughtry Family Department of Surgery, University of Miami Miller School of Medicine, Ryder Trauma Center, 1800 NW 10 Avenue Suite T-247, Miami, FL, 33136-1018, USA
| | - H Lieberman
- Division of Trauma Surgery and Surgical Critical Care, Dewitt-Daughtry Family Department of Surgery, University of Miami Miller School of Medicine, Ryder Trauma Center, 1800 NW 10 Avenue Suite T-247, Miami, FL, 33136-1018, USA
| | - C Marini
- Division of Trauma Surgery and Surgical Critical Care, Dewitt-Daughtry Family Department of Surgery, University of Miami Miller School of Medicine, Ryder Trauma Center, 1800 NW 10 Avenue Suite T-247, Miami, FL, 33136-1018, USA
| | - J A Asensio
- Division of Trauma Surgery and Surgical Critical Care, Dewitt-Daughtry Family Department of Surgery, University of Miami Miller School of Medicine, Ryder Trauma Center, 1800 NW 10 Avenue Suite T-247, Miami, FL, 33136-1018, USA.
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