Eleven adult patients who underwent surgical treatment for trauma with brachial artery injury were reviewed. The patients were nine males and two females with a mean age of 58.4 years. The causes of injury were six upper extremity avulsion injuries, three blunt injuries, and two glass puncture injuries. The injury types were seven complete/incomplete amputations, two sharp injuries, and two blunt injuries. Injury levels were proximal in three, central in four, and distal in four. The length of defect of the brachial artery on preoperative enhanced CT was 2 to 6 cm.
In the nine cases where limb salvage was possible, the revascularization methods were three end-to-end anastomoses, two end-to-end anastomoses after bone shortening, one bridging vein graft, and three bypasses from the subclavian artery. The mean inhibition time was 6 hours. For sharp injuries or distal injuries, anastomosis could be achieved by end-to-end technique or anastomosis after bone shortening or vein grafting. Proximal avulsion injuries often involve endovascular injuries to the brachial artery and axillary artery, requiring bypass from the subclavian artery to the brachial artery. It is necessary to evaluate the extent of endovascular injury as well as the length of the defect on enhanced CT.
