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The Journal of Cardiovascular Surgery 1998 April;39(2):167-9

language: English

Trau­matic pseu­do­aneu­rysm of the axil­lary ­artery fol­lowing ante­rior dis­lo­ca­tion of the ­shoulder. Case ­report

Julia J., Lozano P., Gomez F., Corominas C.

From the Depart­ment of Angi­ology and Vas­cular Sur­gery Son ­Dureta Hos­pital, ­Palma de Mal­lorca, ­Spain


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Vas­cular com­pli­ca­tions are ­rare in ­cases of ­simple ante­rior dis­lo­ca­tion of the ­shoulder but the axil­lary ­artery or its ­branches may be dam­aged. ­Very few ­cases are ­found in the lit­er­a­ture ­reporting ­false aneu­rysms of axil­lary ­artery sec­on­dary to ­blunt ­trauma to the ­shoulder. A ­case of pseu­do­aneu­rysm of the axil­lary ­artery in a 75- ­year-old ­woman is ­reported. Diag­nosis was sus­pected ­because ­large pec­toral hae­matoma ­with hae­mod­y­namic ­instability ­appeared a few ­hours ­later ­after ­manual reduc­tion of the dis­lo­ca­tion. The pseu­do­aneu­rysm was con­firmed ­with selec­tive angio­graphy of the axil­lary ­artery. Arter­i­og­raphy ­should be per­formed when­ever vas­cular ­injury is sus­pected. ­Delayed rec­og­ni­tion of ­these ­lesions may ­lead to per­ma­nent neu­ro­logic def­i­cits ­despite ade­quate vas­cular ­repair of the axil­lary ­artery. A coor­di­nated vas­cular and ortho­paedic ­approach and ­prompt sur­gical treat­ment may ­assure ­full ­upper ­limb func­tion. ­Although endo­vas­cular treat­ment of ­these ­lesions ­could ­seem attrac­tive, we ­prefer to use ­open sur­gical tech­niques ­because ­they ­allow us to ­treat fre­quent con­com­i­tant inju­ries and per­form decom­pres­sion of the ­axillar ­fossa ­because of the ­large hae­matoma.

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