Ten-Year Single-Centre Experience in Managing Traumatic Subclavian and Axillary Artery Injuries

Purpose Trauma-induced injuries to the subclavian and axillary arteries are rare. Treatment options include open repair and endovascular procedures, and the selection ofthe appropriate modality requires careful consideration. We aimed to evaluate the management of traumatic subclavian and axillary artery injuries at a single trauma center. Methods This single-center retrospective study analyzed the medical records of 12 patients who sustained injuries to the subclavian and axillary arteries between January 2013 and January 2023. Injury grading was categorized as follows: grade A, minimal injury (intima only); grade B, vessel laceration <25%; grade C, laceration 25–50%; grade D, laceration >50%; grade E, pseudoaneurysm; grade F, vessel transection; and grade G, occlusion. Patient outcomes, including in-hospital mortality, limb salvage and length of stay (LOS) in the hospital and intensive care unit (ICU), were identified. Results The mean age of the patients was 52.5±16.4 years, and 67% were males. The mean Injury Severity Score (ISS) was 22±4. The in-hospital mortality rate was 17% (n=2), and none of the patients required amputation. The median hospital LOS was 48 days (interquartile range [IQR], 22–71 days) and the median ICU LOS was 4 days (IQR, 2–22 days). When categorized into open repair, endovascular repair, and observation groups, a significant difference was observed in injury grade but not in ISS, LOS, or ICU LOS. Conclusion When managing patients with traumatic subclavian and axillary artery injuries, it is crucial to consider the patient's hemodynamic status and the degree of the injury.