Cervicothoracic vascular injuries. Presentation, management, and outcome.

One hundred consecutive patients with cervicothoracic vascular trauma were analyzed. The injury severity score, mechanism of injury, age, initial findings, management, and results were tabulated. There were 48 arterial and 61 venous injuries in the stable Group A patients, 11 arterial and 12 venous injuries in the unstable Group B patients, and three arterial and five venous injuries in the morbid Group C patients. Treatment included primary repair, resection with end-to-end anastomosis, or ligation. Twenty-three patients developed postoperative complications, the most common being respiratory in nature. The overall mortality rate was six per cent. Five patients died during or immediately after operation of exsanguination, and one died of ischemic brain death on the seventh postinjury day. The usefulness of preoperative angiograms, especially in the detection of arteriovenous fistulas, is important in planning the surgical approach. The overall outcome was favorable.