Traumatic Vascular Disruption in the Thoracocervical Region: Surgical Outcome and Predictors of Survival

Traumatic vascular injury in the thoracocervical region is associated with significant morbidity and mortality. The goal of this study was to examine surgical outcome of these injuries and to establish predictors of survival. The medical records of all patients sustaining traumatic injury to the carotid, vertebral, subclavian, and proximal axillary vessels and undergoing operative repair were retrospectively reviewed. Sixteen patients (11 men, 5 women, mean age 31.1 ±16.6) during a four-year period underwent emergent surgical repair for traumatic vascular disruption. There were 6 lesions of the carotid, 7 of the subclavian, and 2 of the proximal axillary vessels and 1 vertebral artery injury. Sixty- two percent of the patients were hemodynamically unstable on admission. In these patients the diagnosis was established by clinical examination. Hemodynamically stable patients with a high index of suspicion for vascular injury underwent urgent arteriog raphy to confirm the diagnosis and assist in the operativ...