[Surgical treatment of great vessel injuries of thoracic outlet].

OBJECTIVE

To summarize the experience in surgical treatment of great vessel injury of the thoracic outlet.

METHODS

Thirty-two cases (24 men and 8 women aged 2-48 years) treated by surgery were collected during the period of 1970-1998. Sharp injury, blunt injury or decelerated injury was the causes. The vessels of injury included the common carotid artery, subclavian artery and accompanying veins. Emergency suture or repair of the artery with polyester patch was performed in 15 patients, aneurysmectomy in 6, resection of vessels with end-to-end anastomosis in 5, Gore-Tex vessel reconstruction in 2, and transplantation of the great saphenous vein in 3.

RESULTS

Twenty-four patients (75%) were cared and 7 (21.8%) died.

CONCLUSIONS

In the early period, patients with great vessel injury of the thoracic outlet died from acute bleeding, cerebral ischemia or combined multiple injuries, in the later period, however, false aneurysm develop. The operation is appropriate to the recondition of damaged cut, the effect of evolution in false aneurysm is approving. For large damaged cut or for bigger vessel injuries, the repair with polyester patch, Gore-Tex of blood vessel reconstruction or the transplantation of the great saphenous vein must be used.