Almadwahi Nabeel, Halboob Emad
Department of Vascular Surgery, Al-Thawra Modern General Hospital, Sana'a, Yemen.
Faculty of Medicine and Health Sciences, Sana'a University, Sana'a, Yemen.
Int Med Case Rep J. 2022 Nov 24;15:671-675. doi: 10.2147/IMCRJ.S388186. eCollection 2022.
Penetrating trauma involving the subclavian vessels is rare but associated with life- threatening sequelae, including hemomediastinum, formation of pseudoaneurysm and limb ischemia. Conventional open surgery and endovascular repairs are effective treatment modalities for subclavian-related injuries, but the latter has become more attractive owing to being less invasive and less procedure-related complications. We report a case with left subclavian artery pseudoaneurysm secondary to a bomb blast. The patient was successfully treated by surgical repairs using a combination of supra- and infraclavicular approaches. The patient recovered completely and discharged home on the third day. In a resource-limited setting, traditional surgical repair is an effective therapy for posttraumatic pseudoaneurysm, especially when the adjacent organs are compressed by the pseudoaneurysm. Vascular injury should be suspected once a patient presents with localized pulsatile mass in the clavicular region following roadside bomb blasts injuries.
涉及锁骨下血管的穿透性创伤很少见，但会伴有危及生命的后遗症，包括血胸、假性动脉瘤形成和肢体缺血。传统的开放手术和血管内修复是治疗锁骨下相关损伤的有效方法，但由于侵入性较小且手术相关并发症较少，后者变得更具吸引力。我们报告一例因炸弹爆炸继发左锁骨下动脉假性动脉瘤的病例。该患者通过联合使用锁骨上和锁骨下方法进行手术修复，成功治愈。患者完全康复，第三天出院。在资源有限的情况下，传统手术修复是创伤后假性动脉瘤的有效治疗方法，尤其是当假性动脉瘤压迫相邻器官时。一旦患者在路边炸弹爆炸受伤后在锁骨区域出现局部搏动性肿块，就应怀疑血管损伤。
