Abstract/Description
INTRODUCTION: Subclavian and axillary artery injuries are rare but life-threatening. Optimal management strategies remain debated. This study compares injury characteristics and outcomes.
METHODS: Retrospective analysis was conducted on 181 PROOVIT Database patients categorized by injury location, mechanism, and treatment (open, endovascular, nonoperative). Collected data includes ISS, PRBC, mortality, hospital and ICU LOS, and hard signs.
RESULTS: Subclavian injuries had higher ISS (μ=25, 19; p=0.004) and mortality (18%, 3.4%; p=0.004), but fewer hard signs (41%, 63%; p=0.004) than axillary. Axillary injuries were more frequently treated with open repair (51%, 32%; p=0.016), while subclavian injuries were more often managed nonoperatively (45%, 29%; p=0.039). Penetrating injuries had significantly higher PRBC use (μ=8.9, 3.5; p < 0.001) and hard signs (73%, 27%; p < 0.001) compared to blunt, but shorter hospital LOS (μ=11, 15; p=0.018). Open repair had significantly higher hard signs (78%, 49%; p < 0.001), PRBC use (μ=11, 2.8; p < 0.001) and mortality (18%, 2.5%; p=0.041) than endovascular.
CONCLUSION: Open repair remains the predominant treatment for subclavian and axillary injuries, having significantly more PRBC use and hard signs than other treatments, as well as higher mortality than endovascular repair. Hospital LOS, ICU LOS, and ISS did not differ between treatment groups. Axillary injuries and penetrating mechanisms underwent significantly more open repairs. Subclavian injuries had higher ISS and mortality and were significantly more likely to be managed nonoperatively. These findings highlight differences in injury characteristics while reinforcing the continued role of open repair in vascular trauma.
Faculty Advisor/Mentor
Michael Martyak
Faculty Advisor/Mentor Department
Vascular Surgery
College/School/Affiliation
Sentara
Included in
Characteristics and Outcomes of Axillary and Subclavian Artery Injuries
INTRODUCTION: Subclavian and axillary artery injuries are rare but life-threatening. Optimal management strategies remain debated. This study compares injury characteristics and outcomes.
METHODS: Retrospective analysis was conducted on 181 PROOVIT Database patients categorized by injury location, mechanism, and treatment (open, endovascular, nonoperative). Collected data includes ISS, PRBC, mortality, hospital and ICU LOS, and hard signs.
RESULTS: Subclavian injuries had higher ISS (μ=25, 19; p=0.004) and mortality (18%, 3.4%; p=0.004), but fewer hard signs (41%, 63%; p=0.004) than axillary. Axillary injuries were more frequently treated with open repair (51%, 32%; p=0.016), while subclavian injuries were more often managed nonoperatively (45%, 29%; p=0.039). Penetrating injuries had significantly higher PRBC use (μ=8.9, 3.5; p < 0.001) and hard signs (73%, 27%; p < 0.001) compared to blunt, but shorter hospital LOS (μ=11, 15; p=0.018). Open repair had significantly higher hard signs (78%, 49%; p < 0.001), PRBC use (μ=11, 2.8; p < 0.001) and mortality (18%, 2.5%; p=0.041) than endovascular.
CONCLUSION: Open repair remains the predominant treatment for subclavian and axillary injuries, having significantly more PRBC use and hard signs than other treatments, as well as higher mortality than endovascular repair. Hospital LOS, ICU LOS, and ISS did not differ between treatment groups. Axillary injuries and penetrating mechanisms underwent significantly more open repairs. Subclavian injuries had higher ISS and mortality and were significantly more likely to be managed nonoperatively. These findings highlight differences in injury characteristics while reinforcing the continued role of open repair in vascular trauma.