Treatment Strategies and Long-Term Outcomes in Shoulder Girdle Vascular Trauma
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ID: 315774
2026
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Abstract
Abstract Background Traumatic injuries of the subclavian and axillary arteries are rare and associated with fractures and dislocations of the shoulder girdle, often accompanied by polytrauma and neurologic lesions. Management options include open surgical repair and endovascular techniques, however comparative data on outcomes and long-term patency remain limited. Aims To evaluate open and endovascular treatment strategies and to compare short- and long-term outcomes in patients with traumatic subclavian or axillary artery injuries treated at a single center. Methods All patients treated for traumatic injuries of the subclavian or axillary arteries between 2010 and 2025 were retrospectively reviewed. Demographics, injury mechanisms, associated injuries, clinical presentation, treatment modality, technical success, 30-day mortality, patency, and long-term outcomes were analyzed. Results 16 patients were included (mean age 63 years, range 17-88; 56% female). Injuries involved the subclavian artery in 3 patients and the axillary artery in 13 patients. Concomitant brachial plexus injury was present in 75%. Associated skeletal injuries included shoulder dislocations (n=7), humerus- (n=6), clavicle- (n=2) and rib fractures (n=1). Ischemia due to arterial occlusion occurred in 62.5% of patients, while 37.5% presented with active bleeding. Trauma mechanisms included winter sports (32%), pedestrian (25%), traffic (25%), domestic (13%), and agriculture (6%) accidents. Treatment consisted of open repair in 50%, endovascular repair in 31%, hybrid procedures in 6% and isolated arterial repositioning in 13%. Technical success was achieved in all cases. Thirty-day mortality was 6%. Mean follow-up was 2 years (range 0-13). Primary and secondary patency rates were 82% and 100%, respectively. Two patients required a subclavian-axillary bypass and one patient angioplasty to achieve secondary patency. Persistent impairment was mainly related to brachial plexus injuries, with 47% showing residual motor or sensory deficit. Conclusion Both open and endovascular approaches achieve durable patency in vascular trauma of the shoulder girdle. Long-term functional outcome is primarily determined by associated neurological injuries rather than the vascular repair technique.
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| Authors | A Sommerau, S Hofer |
| Journal | the british journal of surgery |
| Year | 2026 |
| DOI |
10.1093/bjs/znag055.080
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| URL | |
| Keywords | Keywords not found |
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