Vasc Spec Int.  2022 Jun;38(2):14. 10.5758/vsi.220012.

Subclavian-Brachial Bypass for Chronic Limb Threatening Ischemia Associated with an Old Motorcycle Accident

• Martínez-Quesada JI
• Anaya-Ayala JE
• Terán-Ellis SMy
• Miranda-Ramírez M
• Arzola LH
• Ruben-Castillo C
• Aramburo JC
• de los Ríos JM
• Hinojosa CA

• KMID: 2530926
• DOI: http://doi.org/10.5758/vsi.220012

Abstract

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 subclavianbrachial 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.

Keyword

Fracture; Subclavian artery; Chronic limb-threatening ischemia; Vascular injuries; Vascular grafting