Graham J M, Mattox K L, Feliciano D V, DeBakey M E
Ann Surg. 1982 Feb;195(2):232-8. doi: 10.1097/00000658-198202000-00020.
Between January 1970 and December 1980, 65 patients sustaining 85 vascular injuries of the axillary artery and/or vein were managed at the Ben Taub General Hospital in Houston, Texas. Concomitant injuries of the subclavian and/or brachial vessels were noted in 34 per cent of patients. A variety of exposure techniques was used in approaching the axillary vessels. Emphasis upon preservation of collateral vessels led to an increased use of substitute vascular conduits over end-to-end anastomosis. The ready availability of prosthetic conduits, absence of graft infection, and excellent short-term patency have made them a primary choice for axillary arterial reconstruction in our recent experience. Associated brachial plexus injury (35%) accounted for the most significant long-term morbidity. The operative mortality was 3.1%, and one patient required upper extremity amputation following failure of repeated revascularization attempts.
1970年1月至1980年12月期间，得克萨斯州休斯顿市本陶布综合医院收治了65例腋动脉和/或腋静脉血管损伤患者，共85处血管损伤。34%的患者伴有锁骨下和/或肱血管损伤。在显露腋血管时采用了多种显露技术。由于强调保留侧支血管，与端端吻合术相比，替代血管导管的使用有所增加。人工血管导管随时可用、无移植物感染且短期通畅率极佳，在我们最近的经验中，这些因素使其成为腋动脉重建的首选。相关的臂丛神经损伤（35%）是最主要的长期致残原因。手术死亡率为3.1%，1例患者在多次血管再通尝试失败后需要截肢。
