Skip to main content
Erschienen in: European Journal of Trauma and Emergency Surgery 5/2011

01.10.2011 | Review Article

Brachial vessel injuries: high morbidity and low mortality injuries

verfasst von: T. Vu, J. A. Asensio, F. N. Mazzini, J. D. Sciarretta, J. Chandler, E. H. Lieberman, M. Ksycki, L. Pizano

Erschienen in: European Journal of Trauma and Emergency Surgery | Ausgabe 5/2011

Einloggen, um Zugang zu erhalten

Abstract

Introduction

Reports of arterial injuries from both the civilian and military arenas report the brachial artery as the most frequently injured vessel, accounting for approximately 25–33% of all peripheral arterial injuries. The brachial artery is surrounded by important peripheral nerves —the median, ulnar and radial, and also parallels the humerus and associated veins. Due to its close proximity to these structures, associated nerve and osseous injuries are frequent with residual neuropathy from such nerve injuries, often the main sources of permanent disability.

Materials and methods

Systematic review of the literature, with emphasis in the diagnosis, treatment and outcomes of these injuries, incorporating the authors experience.

Conclusions

The morbidity and mortality rates associated with brachial artery injuries depend on the cause of the injury itself, which vein or tendon is injured, and whether musculoskeletal and nerve injuries are also present. During the last 20 years, amputation associated with upper extremity arterial injuries has decreased to a rate of 3% because of advances in the treatment of shock, the use of antibiotic therapy, and increased surgical experience.
Literatur
1.
Zurück zum Zitat Hallowell L. Extract of a letter from Mr. Lambert, surgeon at Newcastle upon Tyne, to Dr. Hunter, giving an account of a new method of treating an aneurysm. Med Obser Inq. 1762;2:360. Hallowell L. Extract of a letter from Mr. Lambert, surgeon at Newcastle upon Tyne, to Dr. Hunter, giving an account of a new method of treating an aneurysm. Med Obser Inq. 1762;2:360.
3.
Zurück zum Zitat Jones AR. Two cases illustrating effect of severance of the brachial artery. Proc R Soc Med. 1919;12(Neurol Sect):33–5.PubMed Jones AR. Two cases illustrating effect of severance of the brachial artery. Proc R Soc Med. 1919;12(Neurol Sect):33–5.PubMed
4.
5.
Zurück zum Zitat Padayachy V, Robbs JV, Mulaudzi TV, Pillay B, Paruk N, Moodley P, Ramnarain A. A retrospective review of brachial artery injuries and repairs—is it still a “training artery”? Injury. 2010;41:960–3.PubMedCrossRef Padayachy V, Robbs JV, Mulaudzi TV, Pillay B, Paruk N, Moodley P, Ramnarain A. A retrospective review of brachial artery injuries and repairs—is it still a “training artery”? Injury. 2010;41:960–3.PubMedCrossRef
6.
Zurück zum Zitat Cikrit DF, Dalsing MC, Bryant BJ, Lalka SG, Sawchuk AP, Schulz JE. An experience with upper-extremity vascular trauma. Am J Surg. 1990;160:229–33.PubMedCrossRef Cikrit DF, Dalsing MC, Bryant BJ, Lalka SG, Sawchuk AP, Schulz JE. An experience with upper-extremity vascular trauma. Am J Surg. 1990;160:229–33.PubMedCrossRef
7.
Zurück zum Zitat Rasouli MR, Moini M, Khaji A. Civilian traumatic vascular injuries of the upper extremity: report of the Iranian national trauma project. Ann Thorac Cardiovasc Surg. 2009;15(6):389–93.PubMed Rasouli MR, Moini M, Khaji A. Civilian traumatic vascular injuries of the upper extremity: report of the Iranian national trauma project. Ann Thorac Cardiovasc Surg. 2009;15(6):389–93.PubMed
8.
Zurück zum Zitat Fox CJ, Gillespie DL, O’Donnell SD, Rasmussen TE, Goff JM, Johnson CA, Galgon RE, Sarac TP, Rich NM. Contemporary management of wartime vascular trauma. J Vasc Surg. 2005;41:638–44.PubMedCrossRef Fox CJ, Gillespie DL, O’Donnell SD, Rasmussen TE, Goff JM, Johnson CA, Galgon RE, Sarac TP, Rich NM. Contemporary management of wartime vascular trauma. J Vasc Surg. 2005;41:638–44.PubMedCrossRef
9.
Zurück zum Zitat Kim JYS, Buck DW 2nd, Forte AJV, Subramanian VS, Birman MV, Schierle CF, Kloeters O, Mattox KL, Wall MJ, Epstein MJ. Risk factors for compartment syndrome in traumatic brachial artery injuries: an institutional experience in 139 patients. J Trauma. 2009;67:1339–44.PubMedCrossRef Kim JYS, Buck DW 2nd, Forte AJV, Subramanian VS, Birman MV, Schierle CF, Kloeters O, Mattox KL, Wall MJ, Epstein MJ. Risk factors for compartment syndrome in traumatic brachial artery injuries: an institutional experience in 139 patients. J Trauma. 2009;67:1339–44.PubMedCrossRef
10.
Zurück zum Zitat Kiliç S, Bacakoğlu AK, Göktay AY, Ozkan MH, Ergör G, Bayatli K, Gürbüz A, Ekin A. Evaluation of flow hemodynamics by color-Doppler following two different brachial arterial repair techniques. Eur J Vasc Endovasc Surg. 2004;28:310–6.PubMedCrossRef Kiliç S, Bacakoğlu AK, Göktay AY, Ozkan MH, Ergör G, Bayatli K, Gürbüz A, Ekin A. Evaluation of flow hemodynamics by color-Doppler following two different brachial arterial repair techniques. Eur J Vasc Endovasc Surg. 2004;28:310–6.PubMedCrossRef
11.
Zurück zum Zitat Brown KR, Jean-Claude J, Seabrook GR, Towne JB, Cambria RA. Determinates of functional disability after complex upper extremity trauma. Ann Vasc Surg. 2001;15(1):43–8.PubMedCrossRef Brown KR, Jean-Claude J, Seabrook GR, Towne JB, Cambria RA. Determinates of functional disability after complex upper extremity trauma. Ann Vasc Surg. 2001;15(1):43–8.PubMedCrossRef
12.
Zurück zum Zitat Rich NM, Spencer FC. Vascular trauma. Philadelphia: WB Saunders; 1978. p. 125–56. Rich NM, Spencer FC. Vascular trauma. Philadelphia: WB Saunders; 1978. p. 125–56.
13.
Zurück zum Zitat Levin PM, Rich NM, Hutton JE Jr. Collaternal circulation in arterial injuries. Arch Surg. 1971;102:392–9.PubMed Levin PM, Rich NM, Hutton JE Jr. Collaternal circulation in arterial injuries. Arch Surg. 1971;102:392–9.PubMed
14.
Zurück zum Zitat Degiannis E, Levy RD, Sofianos C, Florizoone MG, Saadia R. Arterial gunshot injuries of the extremities: a South African experience. J Trauma. 1995;39(3):570–5.PubMedCrossRef Degiannis E, Levy RD, Sofianos C, Florizoone MG, Saadia R. Arterial gunshot injuries of the extremities: a South African experience. J Trauma. 1995;39(3):570–5.PubMedCrossRef
15.
Zurück zum Zitat Zellweger R, Hess F, Nicol A, Omoshoro-Jones J, Kahn D, Navsaria P. An analysis of 124 surgically managed brachial artery injuries. Am J Surg. 2004;188:240–5.PubMedCrossRef Zellweger R, Hess F, Nicol A, Omoshoro-Jones J, Kahn D, Navsaria P. An analysis of 124 surgically managed brachial artery injuries. Am J Surg. 2004;188:240–5.PubMedCrossRef
16.
Zurück zum Zitat Endean ED, Veldenz HC, Schwarcz TH, Hyde GL. Recognition of arterial injury in elbow dislocation. J Vasc Surg. 1992;16(3):402–6.PubMedCrossRef Endean ED, Veldenz HC, Schwarcz TH, Hyde GL. Recognition of arterial injury in elbow dislocation. J Vasc Surg. 1992;16(3):402–6.PubMedCrossRef
17.
Zurück zum Zitat Callcut RA, Acher CW, Hoch J, Tefera G, Turnipseed W, Mell MW. Impact of intraoperative arteriography on limb salvage for traumatic popliteal artery injury. J Trauma. 2009;67:252–8.PubMedCrossRef Callcut RA, Acher CW, Hoch J, Tefera G, Turnipseed W, Mell MW. Impact of intraoperative arteriography on limb salvage for traumatic popliteal artery injury. J Trauma. 2009;67:252–8.PubMedCrossRef
18.
Zurück zum Zitat Feliciano DV. Management of peripheral arterial injury. Curr Opin Crit Care. 2010;16:602–8.CrossRef Feliciano DV. Management of peripheral arterial injury. Curr Opin Crit Care. 2010;16:602–8.CrossRef
19.
Zurück zum Zitat Clouse WD, Rasmussen TE, Perlstein J, Sutherland MJ, Peck MA, Eliason JL, Jazerevic S, Jenkins DH.. Upper extremity vascular injury: a current in-theater wartime report from Operation Iraqi Freedom. Ann Vasc Surg. 2006;20:429–34.PubMedCrossRef Clouse WD, Rasmussen TE, Perlstein J, Sutherland MJ, Peck MA, Eliason JL, Jazerevic S, Jenkins DH.. Upper extremity vascular injury: a current in-theater wartime report from Operation Iraqi Freedom. Ann Vasc Surg. 2006;20:429–34.PubMedCrossRef
20.
Zurück zum Zitat Nanobashvili J, Kopadze T, Tvaladze M, Buachidze T, Nazvlishvili G. War injuries of major extremity arteries. World J Surg. 2003;27:134–9.PubMed Nanobashvili J, Kopadze T, Tvaladze M, Buachidze T, Nazvlishvili G. War injuries of major extremity arteries. World J Surg. 2003;27:134–9.PubMed
21.
Zurück zum Zitat Dente CJ, Feliciano DV, Rozycki GS, Cava RA, Ingram WL, Salomone JP, Nicholas JM, Kanakasundaram D, Ansley JP. A review of upper extremity fasciotomies in a level I trauma center. Am Surg. 2004;70:1088–93.PubMed Dente CJ, Feliciano DV, Rozycki GS, Cava RA, Ingram WL, Salomone JP, Nicholas JM, Kanakasundaram D, Ansley JP. A review of upper extremity fasciotomies in a level I trauma center. Am Surg. 2004;70:1088–93.PubMed
22.
Zurück zum Zitat Klocker J, Falkensammer J, Pellegrini L, Biebl M, Tauscher T, Fraedrich G. Repair of arterial injury after blunt trauma in the upper extremity—immediate and long-term outcome. Eur J Vasc Endovasc Surg. 2010;39:160–4.PubMedCrossRef Klocker J, Falkensammer J, Pellegrini L, Biebl M, Tauscher T, Fraedrich G. Repair of arterial injury after blunt trauma in the upper extremity—immediate and long-term outcome. Eur J Vasc Endovasc Surg. 2010;39:160–4.PubMedCrossRef
23.
Zurück zum Zitat Visser PA, Hermreck AS, Pierce GE, Thomas JH, Hardin CA. Prognosis of nerve injuries incurred during acute trauma to peripheral arteries. Am J Surg. 1980;140:596–9.PubMedCrossRef Visser PA, Hermreck AS, Pierce GE, Thomas JH, Hardin CA. Prognosis of nerve injuries incurred during acute trauma to peripheral arteries. Am J Surg. 1980;140:596–9.PubMedCrossRef
24.
Zurück zum Zitat Hardin WD Jr, O’Connell RC, Adinolfi MF, Kerstein MD. Traumatic arterial injuries of the upper extremity: determinants of disability. Am J Surg. 1985;150:266–70.PubMedCrossRef Hardin WD Jr, O’Connell RC, Adinolfi MF, Kerstein MD. Traumatic arterial injuries of the upper extremity: determinants of disability. Am J Surg. 1985;150:266–70.PubMedCrossRef
25.
Zurück zum Zitat Makins G. Gunshot injuries to the blood vessels. Bristol: John Wright and Sons; 1919. Makins G. Gunshot injuries to the blood vessels. Bristol: John Wright and Sons; 1919.
26.
Zurück zum Zitat DeBakey ME, Simeone FA. Battle injuries of the arteries in World War II: an analysis of 2,471 cases. Ann Surg. 1946;123:534–79. DeBakey ME, Simeone FA. Battle injuries of the arteries in World War II: an analysis of 2,471 cases. Ann Surg. 1946;123:534–79.
27.
Zurück zum Zitat Hughes CW. Arterial repair during the Korean War. Ann Surg. 1958;147:555–61. Hughes CW. Arterial repair during the Korean War. Ann Surg. 1958;147:555–61.
28.
Zurück zum Zitat Rich NM. Vascular trauma in Vietnam. J Cardiovasc Surg. 1970;11:368–77. Rich NM. Vascular trauma in Vietnam. J Cardiovasc Surg. 1970;11:368–77.
29.
Zurück zum Zitat Morris GC Jr, Creech O Jr, DeBakey ME. Acute arterial injuries in civilian practice. Am J Surg. 1957;93:565–72. Morris GC Jr, Creech O Jr, DeBakey ME. Acute arterial injuries in civilian practice. Am J Surg. 1957;93:565–72.
30.
Zurück zum Zitat Ferguson IA, Byrd WM, McAfee DK. Experiences in the management of arterial injuries. Ann Surg. 1961;153:980–86. Ferguson IA, Byrd WM, McAfee DK. Experiences in the management of arterial injuries. Ann Surg. 1961;153:980–86.
31.
Zurück zum Zitat Owens JC. The management of arterial trauma. Surg Clin North Am. 1963;43:371–85. Owens JC. The management of arterial trauma. Surg Clin North Am. 1963;43:371–85.
32.
Zurück zum Zitat Smith L, Foran R, Gaspar MR. Acute arterial injuries of the upper extremity. Am J Surg. 1963;106:144–51. Smith L, Foran R, Gaspar MR. Acute arterial injuries of the upper extremity. Am J Surg. 1963;106:144–51.
33.
Zurück zum Zitat Patman R, Poulos E, Shires G. The management of civilian arterial injuries. Surg Gynecol Obstet. 1964;118:725–38. Patman R, Poulos E, Shires G. The management of civilian arterial injuries. Surg Gynecol Obstet. 1964;118:725–38.
34.
Zurück zum Zitat Dillard BM, Nelson DL, Norman HG. Review of 85 major traumatic arterial injuries. Surgery. 1968;63:391–95. Dillard BM, Nelson DL, Norman HG. Review of 85 major traumatic arterial injuries. Surgery. 1968;63:391–95.
35.
Zurück zum Zitat Drapanas T, Hewitt RL, Weichert RF III, Smith AD. Civilian vascular injuries: a critical appraisal of three decades of management. Ann Surg. 1970;172:351–60. Drapanas T, Hewitt RL, Weichert RF III, Smith AD. Civilian vascular injuries: a critical appraisal of three decades of management. Ann Surg. 1970;172:351–60.
36.
Zurück zum Zitat Perry MO, Thal E, Shires G. Management of arterial injuries. Ann Surg. 1971;173:403–8. Perry MO, Thal E, Shires G. Management of arterial injuries. Ann Surg. 1971;173:403–8.
37.
Zurück zum Zitat Cheek RC, Pope JC, Smith HF, et al. Diagnosis and management of major vascular injuries: a review of 200 operative cases. Am Surg. 1975;41:755–60. Cheek RC, Pope JC, Smith HF, et al. Diagnosis and management of major vascular injuries: a review of 200 operative cases. Am Surg. 1975;41:755–60.
38.
Zurück zum Zitat Kelly GL, Eiseman B. Civilian vascular injuries. J Trauma. 1975;15:507–14. Kelly GL, Eiseman B. Civilian vascular injuries. J Trauma. 1975;15:507–14.
39.
Zurück zum Zitat Hardy JD, Raju S, Neely WA, Berry DW. Aortic and other arterial injuries. Ann Surg. 1975;181:640–53. Hardy JD, Raju S, Neely WA, Berry DW. Aortic and other arterial injuries. Ann Surg. 1975;181:640–53.
40.
Zurück zum Zitat Bole PV, Purdy RT, Munda RT, et al. Civilian arterial injuries. Ann Surg. 1976;183:13–23. Bole PV, Purdy RT, Munda RT, et al. Civilian arterial injuries. Ann Surg. 1976;183:13–23.
41.
Zurück zum Zitat Cikrit DF, Dalsing MC, Bryant BJ, Lalka SG, Sawchuk AP, Schulz JE. An experience with upper-extremity vascular trauma. Am J Surg. 1990;160(2):229–33. Cikrit DF, Dalsing MC, Bryant BJ, Lalka SG, Sawchuk AP, Schulz JE. An experience with upper-extremity vascular trauma. Am J Surg. 1990;160(2):229–33.
42.
Zurück zum Zitat Degiannis E, Levy RD, Sliwa K, Potokar T, Saadia R. Penetrating injuries of the brachial artery. Injury. 1995;26(4):249–52. Degiannis E, Levy RD, Sliwa K, Potokar T, Saadia R. Penetrating injuries of the brachial artery. Injury. 1995;26(4):249–52.
43.
Zurück zum Zitat Zellweger R, Hess F, Nicol A, Omoshoro-Jones J, Kahn D, Navsaria P. An analysis of 124 surgically managed brachial artery injuries. Am J Surg. 2004;188(3):240–5. Zellweger R, Hess F, Nicol A, Omoshoro-Jones J, Kahn D, Navsaria P. An analysis of 124 surgically managed brachial artery injuries. Am J Surg. 2004;188(3):240–5.
44.
Zurück zum Zitat Ergunes K, Yilik L, Ozsoyler I, Kestelli M, Ozbek C, Gurbuz A. Traumatic brachial artery injuries.Tex Heart Inst J. 2006;33(1):31–4. Ergunes K, Yilik L, Ozsoyler I, Kestelli M, Ozbek C, Gurbuz A. Traumatic brachial artery injuries.Tex Heart Inst J. 2006;33(1):31–4.
45.
Zurück zum Zitat Rasouli MR, Moini M, Khaji A. Civilian traumatic vascular injuries of the upper extremity: report of the Iranian national trauma project. Ann Thorac Cardiovasc Surg. 2009;15(6):389–93. Rasouli MR, Moini M, Khaji A. Civilian traumatic vascular injuries of the upper extremity: report of the Iranian national trauma project. Ann Thorac Cardiovasc Surg. 2009;15(6):389–93.
46.
Zurück zum Zitat Kim JY, Buck DW 2nd, Forte AJ, Subramanian VS, Birman MV, Schierle CF, Kloeters O, Mattox KL, Wall MJ, Epstein MJ. Risk factors for compartment syndrome in traumatic brachial artery injuries: an institutional experience in 139 patients. J Trauma. 2009;67(6):1339–44. Kim JY, Buck DW 2nd, Forte AJ, Subramanian VS, Birman MV, Schierle CF, Kloeters O, Mattox KL, Wall MJ, Epstein MJ. Risk factors for compartment syndrome in traumatic brachial artery injuries: an institutional experience in 139 patients. J Trauma. 2009;67(6):1339–44.
Metadaten
Titel
Brachial vessel injuries: high morbidity and low mortality injuries
verfasst von
T. Vu
J. A. Asensio
F. N. Mazzini
J. D. Sciarretta
J. Chandler
E. H. Lieberman
M. Ksycki
L. Pizano
Publikationsdatum
01.10.2011
Verlag
Springer-Verlag
Erschienen in
European Journal of Trauma and Emergency Surgery / Ausgabe 5/2011
Print ISSN: 1863-9933
Elektronische ISSN: 1863-9941
DOI
https://doi.org/10.1007/s00068-011-0143-0

Weitere Artikel der Ausgabe 5/2011

European Journal of Trauma and Emergency Surgery 5/2011 Zur Ausgabe

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.