Abstract
We described a case of an 85-year-old man with subscapular arterial injury who was successfully treated by covered stent placement. He experienced anterior shoulder dislocation after a bike accident. Upon admission, his blood pressure was slightly low, and after manipulative reduction of the dislocation, the blood pressure decreased further. Subsequently, extravasation around the axillary artery was noted on contrast-enhanced computed tomography. In addition, damage of the roots of the subscapular artery was detected on angiography. Therefore, we placed a polytetrafluoroethylene-covered stent in the axillary artery, including the origin of the subscapular artery. Aspirin and clopidogrel treatment was initiated, stent patency was assessed, and the patient was discharged 25 days after admission. As increased peak systolic velocity was noted on vascular ultrasonography 5 months after the injury, angiography was performed, which indicated 50% stenosis; therefore, we performed percutaneous angioplasty. Until 18 months after the injury, only 25% stenosis was noted. Arterial injury associated with shoulder dislocation rarely occurs, but it could be fatal. However, covered stent placement may be effective in case of surgical difficulty. Moreover, a combination of angiography and vascular ultrasonography is useful for evaluation following stent placement.
