1.Subclavian-Brachial Bypass for Chronic Limb Threatening Ischemia Associated with an Old Motorcycle Accident
Jose I. MARTÍNEZ-QUESADA ; Javier E. ANAYA-AYALA ; Santiago Mier y TERÁN-ELLIS ; Montserrat MIRANDA-RAMÍREZ ; Luis H. ARZOLA ; Christopher RUBEN-CASTILLO ; Juan C. ARAMBURO ; Jesus M. DE LOS RÍOS ; Carlos A. HINOJOSA
Vascular Specialist International 2022;38(2):14-
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.
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