A Case of Acute Occlusion of the Brachial Artery due to Strangulation and Traction / 日本心臓血管外科学会雑誌

ABSTRACT

A 61-year-old woman with paresthesia and coldness of the right forearm came to our institute. Her right arm was strangulated and tracted by a vinyl string tied at her right brachium. No pulsation of her right radial artery was detected, and her forearm had swollen with subcutaneous hematoma. Her arteriography showed occlusion of the distal site of the right brachial artery, and just proximal to the brachial arterial bifurcation was enhanced by collaterals. She underwent emergency revascularization 6h after injury. There was a thrombus in the artery at the strangulated site, and the arterial intima was circumferentially dissected. The injured site of the artery was completely resected and interposed with basilic vein. Although 8h had passed from injury to reperfusion, myonephropathic metabolic syndrome did not occur after the operation. Her brachial arterial pulsation is now well palpable. The arterial occlusion was probably caused by the circumferential tear of the intima due to not only direct strangulation but also strong traction of the arm. It is necessary to resect a sufficient length of injured artery.