Endovascular stent-graft placement for treatment of traumatic penetrating subclavian artery injury.

Civilian vascular trauma has increased over the past decade with a concurrent surge in the use of firearms. Penetrating trauma accounts for approximately 90% of arterial injuries. These are often difficult to diagnose and treat. Early descriptions of the diagnosis and management of traumatic vascular injuries came from both military and civilian trauma surgeons. Trauma patients frequently have multiple injuries, complicating routine approaches to vascular repair. Acute subclavian artery injuries, which are now appearing more frequently in trauma centers as trauma care is regionalized, are especially difficult to treat because of the difficulty in obtaining adequate exposure even when the injury is isolated. Endovascular stentgraft placement offers a new and less invasive technique for the treatment of acute traumatic vascular injuries. We present a patient with traumatic disruption of the subclavian artery whose injury was successfully managed with an endovascular stentgraft.