Treatment of Brachial Artery Injury with Humeral Shaft Fracture Using Endovascular Stenting

Suk Kang; Phil-Hyun Chung; Chung-Soo Whang; Jong-Pil Kim; Young-Sung Kim; Chul-Ho Yang; Duk-Young Na

doi:10.4055/jkoa.2010.45.6.490

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Kang, Chung, Whang, Kim, Kim, Yang, and Na: Treatment of Brachial Artery Injury with Humeral Shaft Fracture Using Endovascular Stenting

Case Report

Journal of the Korean Orthopaedic Association

Journal of the Korean Orthopaedic Association 2010; 45(6): 490-495.

Published online: 24 December 2010

DOI: https://doi.org/10.4055/jkoa.2010.45.6.490

Treatment of Brachial Artery Injury with Humeral Shaft Fracture Using Endovascular Stenting

Suk Kang, M.D., Phil-Hyun Chung, M.D., Chung-Soo Whang, M.D., Jong-Pil Kim, M.D., Young-Sung Kim, M.D., Chul-Ho Yang, M.D., Duk-Young Na, M.D.^*

Department of Orthopedic Surgery, Dongguk University College of Medicine, Gyeongju, Korea.

^*Department of Internal Medicine, Dongguk University College of Medicine, Gyeongju, Korea.

Correspondence to: Jong-Pil Kim, M.D. Department of Orthopedic Surgery, Dongguk University College of Medicine, 1090-1, Seokjang-dong, Gyeongju 780-350, Korea. TEL: +82-54-770-8221 FAX: +82-54-770-8378, kjpil@dongguk.ac.kr

Received 8 April 2010 Accepted 26 June 2010

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

An injury to the brachial artery from humeral shaft fracture is uncommon but requires immediate surgery to restore the blood flow. We report a case of endovascular stenting to repair a brachial artery occlusion caused by humeral shaft fracture in a 53 year old male with a review of the relevant literature.

Keywords: upper arm, brachial artery injury, humeral shaft fracture, endovascular stent

Figures and Tables

Figure 1

Initial radiograph shows comminuted fracture of the proximal 1/3 humeral shaft.

Figure 2

Upper extremity angiography shows complete occlusion of the brachial artery and deep brachial artery at the level of the humeral fracture.

Figure 3

Distal brachial artery segment is filled by collateral circulation and there is no extravasation of contrast media.

Figure 4

A running through guide wire was passed to distal brachial artery segment.

Figure 5

Endovascular stent is expanded by ballooning.

Figure 6

On post-stenting angiogram, the occluded portion of brachial artery is successfully connected without evidence of leakage.

Figure 7

The humeral fracture was fixed with locking plate and screws.

Figure 8

At 6 weeks after operation, a radiograph shows slight narrowing of distal portion of grafted stent.

Figure 9

Computer tomography angiogram shows well maintained distal artery outflow.

References

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