Management of subclavian vascular injuries.

摘要: Greater civilian use of firearms and improved transportation resuscitation the injured have provided our institutions with an increasing experience subclavian vascular injuries. Ninety-three patients injuries are presented two time periods compared. Principles management gained from earlier been utilized a decline in mortality to 4.7% among admitted palpable pulse or blood pressure. Successful treatment as before still lies recognition severity injury, rapidity preparation for operation, adequacy surgical exposure. Recent trends included increased reliance on selective arteriography when patient is stable, extensive 'book' thoracotomy primary incision, preoperative intraoperative autotransfusion, more frequent interposition grafting repair. Primary arterial repair was seldom accomplished; most required segmental resection end-to-end anstomosis grafts.