Contemporary Management of Axillo-subclavian Arterial Injuries Using Data from the AAST PROOVIT Registry


  • Grahya Guntur
  • Joseph J DuBose
  • Tiffany K Bee
  • Timothy Fabian
  • Jonathan Morrison
  • David J Skarupa
  • Kenji Inaba
  • Rishi Kundi
  • Thomas Scalea
  • David V Feliciano



Axillo-subclavian Injury, Endovascular Repair, Vascular, Trauma


Background: Endovascular repair has emerged as a viable repair option for axillo-subclavian arterial injuries in select patients; however, further study of contemporary outcomes is warranted.

Methods: The American Association for the Surgery of Trauma (AAST) PROspective Observational Vascular Injury Treatment (PROOVIT) registry was used to identify patients with axillo-subclavian arterial injuries from 2013 to 2019. Demographics and outcomes were compared between patients undergoing endovascular repair versus open repair.

Results: 167 patients were identified, with intervention required in 107 (64.1%). Among these, 24 patients underwent open damage control surgery (primary amputation = 3, ligation = 17, temporary vascular shunt = 4). The remaining 83 patients (91.6% male; mean age 26.0 ± 16) underwent either endovascular repair (36, 43.4%) or open repair (47, 56.6%). Patients managed with definitive endovascular or open repair had similar demographics and presentation, with the only exception being that endovascular repair was more commonly employed for traumatic pseudoaneurysms (p = 0.004). Endovascular repair was associated with lower 24-hour transfusion requirements (p = 0.012), but otherwise the two groups were similar with regards to in-hospital outcomes.

Conclusion: Endovascular repair is now employed in > 40% of axillo-subclavian arterial injuries undergoing repair at initial operation and is associated with lower 24-hour transfusion requirements, but otherwise outcomes are comparable to open repair.




How to Cite

Guntur, G., DuBose, J. J., Bee, T. K., Fabian, T., Morrison, J., Skarupa, D. J., … Feliciano, D. V. (2021). Contemporary Management of Axillo-subclavian Arterial Injuries Using Data from the AAST PROOVIT Registry. Journal of Endovascular Resuscitation and Trauma Management, 5(2), 77–82.



Original Article

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