Endovascular Treatment of a Traumatic Axillary Artery Rupture Using the Dual Bull’s-Eye Technique

Ann Vasc Surg . 2020 Nov;69:447.e17-447.e21. doi: 10.1016/j.avsg.2020.05.025. Epub 2020 May 29.

Fecha de la publicación: 20/05/2020

Autor: Carmen González Canga (1), Sara Busto Suárez (2), Lino Antonio Camblor Santervás (2), Florentino Vega García (3), Amer Zanabili Al-Sibbai (2), Francisco Álvarez Marcos (2), Manuel Alonso Pérez (2)

PMID

Affiliations

1Vascular Surgery Department, Asturias University Central Hospital (HUCA), Oviedo, Spain. Electronic address: carmen.gonzalezcca@sespa.es.

2Vascular Surgery Department, Asturias University Central Hospital (HUCA), Oviedo, Spain.

3Vascular & Interventional Radiology Department, Asturias University Central Hospital (HUCA), Oviedo, Spain.

Abstract

Background: Our purpose is to report a case of an axillary artery rupture treated by endovascular means using the dual bull’s-eye technique. An 83-year-old woman with multiple comorbidities was diagnosed with axillary artery rupture after the reduction of a shoulder dislocation.

Methods: An endovascular repair attempt was made, but, despite the use of a double approach (antegrade and retrograde), reconnecting both ends of the severed artery was deemed not possible. 5-mm Amplatz GooseNeck snares were advanced from each access and superposed in a perpendicular plane. A percutaneous infraclavicular puncture with a lumbar needle was made through both snares, and a V14 guidewire was subsequently introduced. The guidewire was recovered through femoral and brachial accesses, and a 7 × 100 mm covered self-expandable stent was deployed.

Results: The final angiographic control did not show further hemorrhage, and the patient recovered radial pulse. Follow-up showed complete patency and no complications at 9 months after the procedure.

Conclusions: The dual bull’s-eye technique can be used as a resource tool in cases of arterial rupture, when the arterial continuity cannot be re-established by conventional approaches.