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KMID : 1037520220380020014
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Vascular Specialist International
2022 Volume.38 No. 2 p.14 ~ p.14
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Subclavian-Brachial Bypass for Chronic Limb Threatening Ischemia Associated with an Old Motorcycle Accident
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Martinez-Quesada Jose I.
Anaya-Ayala Javier E.
Teran-Ellis Santiago Mier y
Miranda-Ramirez Montserrat W.
Arzola Luis H.
Ruben-Castillo Christopher
Aramburo Juan C.
de los Rios Jesus M.
Hinojosa Carlos A.
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Abstract
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Chronic limb-threatening ischemia is rarely associated with previous traumatic injury. We present a case of a 28-year-old male with progressive digit ulcers, a weak pulse, cyanosis, and a cold limb. Eight months prior, he had a motorcycle accident resulting in a right clavicle fracture and brachial plexus injury. Computed tomography angiography revealed occlusion of the right subclavian artery near a surgically implanted reduction plate. The patient underwent an open subclavian-brachial bypass with a reversed saphenous vein graft. His postoperative recovery was uneventful. After 3 months, he had a euthermic right hand with a palpable pulse and his ulcers had completely healed. This case reinforces the need for patients with a neurological deficit in the upper extremity caused by blunt trauma to undergo thorough vascular examination to identify potential arterial injury and compromised perfusion.
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