Case Report

CT Angiogram and Endovascular Stent Graft for an Axillary Artery Gunshot Wound

Authors: George M. Testerman, MD, G Daniel Gonzalez, MD, Elizabeth Dale, MD

Abstract

A patient with an axillary artery gunshot wound pseudoaneurysm was evaluated and managed with computed tomographic angiogram and endovascular stent graft. Vascular injuries resulting from penetrating trauma or interventional vascular procedures are relatively uncommon. Subclavian and axillary arterial injuries may be associated with substantial morbidity and mortality if not managed expeditiously. The inaccessibility of these arteries makes stent graft treatment particularly attractive. The stable patient with a pseudoaneurysm or an arteriovenous fistula seems to be the ideal candidate to treat in this way. As computed tomography (CT) technology has evolved, CT angiography has become an integral part of the initial assessment of proximal extremity vascular injuries.


Key Points


* Subclavian and axillary vascular injuries are associated with high mortality and morbidity rates.


* As computed tomography technology has evolved, multislice helical computed tomographic angiography has become an integral part of the initial assessment of these injuries.


* Recently, an endovascular approach with covered stents has been used to treat subclavian and axillary artery injuries.

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