Fatimi Saulat-H, Anees Amna, Muzaffar Marium, Hanif Hashim-M
Department of Surgery, Division of Cardiothoracic Surgery, Aga Khan University, Karachi, Pakistan.
Chin J Traumatol. 2010 Aug 1;13(4):255-6.
Subclavian artery thrombosis is a rare complication of clavicle fractures. We reported a 20-year-old man who was admitted to the emergency room after a road traffic accident. He was a pedestrian who was initially hit by a bus and after he fell down on the road, he was run over by a car. On evaluation, he was found to have multiple facial and rib fractures, distal right humerus and right clavicle fracture. Significantly, right radial pulse was absent. After further evaluation including Doppler studies and an angiography which revealed complete obstruction of right subclavian artery just distal to its 1st portion, the patient was urgently taken to the operation room. A midclavicular fracture was adjacent to the injured vessel. We established proximal and distal control, removed damaged part. After mobilizing the subclavian artery, an end-to-end anastomosis was made. Then open reduction and internal fixation of right distal humerus was performed. The rest of the postoperative course was unremarkable. To prevent complications of subclavian artery thrombosis, different treatment modalities can be used, including anticoagulation therapy, angioplasty, stenting and bypass procedures.
锁骨下动脉血栓形成是锁骨骨折的一种罕见并发症。我们报道了一名20岁男性,在一次道路交通事故后被送往急诊室。他是一名行人,最初被一辆公共汽车撞倒,摔倒在路上后又被一辆汽车辗过。经评估,发现他有多根面部和肋骨骨折、右肱骨远端和右锁骨骨折。值得注意的是,右侧桡动脉搏动消失。经过包括多普勒检查和血管造影在内的进一步评估,发现右锁骨下动脉在其第一部分远端完全阻塞,该患者被紧急送往手术室。锁骨中段骨折与受损血管相邻。我们建立了近端和远端控制,切除受损部分。在游离锁骨下动脉后,进行了端端吻合。然后对右肱骨远端进行了切开复位内固定。术后其余过程无异常。为预防锁骨下动脉血栓形成的并发症,可采用不同的治疗方式,包括抗凝治疗、血管成形术、支架置入术和搭桥手术。