CASE REPORTS  VASCULAR PAPERS 

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

Copyright © 2000 EDIZIONI MINERVA MEDICA

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

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.