Author(s)

Raminta Černevičiūtė¹, Shaheel M. Sahebally², Ahmad Mourad³, Donatas Inčiūra³, Aleksandras Antuševas³

¹Faculty of Medicine, Lithuanian University of Health Sciences, Kaunas, Lithuania.
²Department of Surgery, University College Hospital Galway, Galway, Ireland.
³Department of Cardiac, Thoracic and Vascular Surgery, Lithuanian University of Health Sciences, Hospital of Lithuanian University of Health Sciences Kaunas Clinics, Kaunas, Lithuania.

Acute upper limb ischemia caused by a gunshot penetrating vascular injury and subsequent arterial embolization by foreign body is uncommon in everyday practice and is associated with high morbidity/mortality rates, especially with emergency surgery. We present the case of a 72-year old male who attempted suicide using a gun. A gunshot entry wound was evident in the right upper chest region with no pellet exit wound. Radial pulses were palpable bilaterally. Angiography revealed right subclavian artery direct injury and pellet embolization to the brachial artery. The patient underwent open surgery, with reversed saphenous vein interposition graft to replace subclavian artery defect. A pellet was removed by a separate arteriotomy in the brachial artery. Associated injuries were clavicle-comminuted fracture and subclavian vein injury. The patient remained well 5 months later with no reported complications. In conclusions, the presence of radial pulses alone on clinical exam cannot rule out the presence of a significant vascular injury.

Gunshot Wound, Pellet Embolization, Arterial Trauma, Upper Extremity, Case Report

Černevičiūtė, R. , Sahebally, S. , Mourad, A. , Inčiūra, D. and Antuševas, A. (2017) Pellet Embolization after Subclavian Artery Injury: A Case Report. Surgical Science, 8, 444-450. doi: 10.4236/ss.2017.810049.