Zelenock G B, Kazmers A, Graham L M, Erlandson E E, Cronenwett J L, Whitehouse W M, Wakefield T W, Lindenauer S M, Stanley J C
Arch Surg. 1985 Jun;120(6):685-92. doi: 10.1001/archsurg.1985.01390300035006.
Nonpenetrating subclavian artery trauma, a potentially catastrophic injury, has been recognized more frequently with the liberal use of angiography in evaluating blunt cervicothoracic trauma. Six patients, five men and one woman, recently underwent surgical treatment at the University of Michigan Hospital for blunt injury of the subclavian artery. The diagnoses were established by arteriography. Physical findings, chest roentgenograms, and results of noninvasive vascular evaluation were found to be nonspecific or unreliable. Operative treatment with resection of the injured arterial segments and either primary anastomosis or bypass grafting resulted in restoration of distal, upper extremity blood flow in all of the cases. One patient died 20 days after trauma from a severe associated cerebral injury. Among the five survivors, residual soft tissue and neurologic injury compromised full recovery in three. Thus, only two of the six patients survived without sequelae, a fact that underscores the seriousness of this type of subclavian artery injury.
非穿透性锁骨下动脉损伤是一种潜在的灾难性损伤，随着血管造影术在评估钝性颈胸外伤中的广泛应用，这种损伤已被更频繁地认识到。6例患者，5男1女，最近在密歇根大学医院接受了锁骨下动脉钝性损伤的手术治疗。诊断通过动脉造影确定。体格检查、胸部X线片和非侵入性血管评估结果被发现是非特异性的或不可靠的。对受伤动脉段进行切除并进行一期吻合或旁路移植的手术治疗，使所有病例的远端上肢血流得以恢复。1例患者在创伤后20天因严重的相关脑损伤死亡。在5名幸存者中，3人的残余软组织和神经损伤影响了完全康复。因此，6例患者中只有2例存活且无后遗症，这一事实凸显了这种类型的锁骨下动脉损伤的严重性。
