Journal of Trauma and Injury

The Korean Society of Traumatology (대한외상학회)
권호 표지
DOI QR코드

DOI QR Code

Delayed Subclavian Vein Stenosis without Thrombosis Following Clavicle Fracture

  • Kim, Do Wan (Department of Thoracic and Cardiovascular Surgery, Chonnam National University Hospital, Chonnam National University Medical School) ;
  • Jeong, In Seok (Department of Thoracic and Cardiovascular Surgery, Chonnam National University Hospital, Chonnam National University Medical School) ;
  • Na, Kook Joo (Department of Thoracic and Cardiovascular Surgery, Chonnam National University Hwasun Hospital, Chonnam National University Medical School)
  • Received : 2019.08.01
  • Accepted : 2019.12.04
  • Published : 2019.12.30
Download PDF
⟨ Previous Next ⟩

Abstract

Subclavian vein injuries occasionally occur as a sequela of penetrating trauma or vascular access, but have rarely been reported to occur after clavicle fracture. The subclavian vessels are mainly enclosed by the subclavius muscle, the first rib, and the costocoracoid ligament. Therefore, in such cases, subclavian vein injury is rare because of the strcutures surrounding the subclavian vessels. Nevertheless, subclavian vein injuries occasionally show thrombotic manifestations, and thrombosis of the upper limbs constitutes 1-4% of cases of total deep vein thrombosis. Furthermore, to the best of the authors' knowledge, although vessel injuries have been reported after clavicle or rib fractures and nerve injuries to regions such as the brachial plexus, no case involving delayed presentation of isolated subclavian vein stenosis after clavicle fracture due to blunt trauma has yet been reported.

Keywords

References

  1. Clark DD, Albina JE, Chazan JA. Subclavian vein stenosis and thrombosis: a potential serious complication in chronic hemodialysis patients. Am J Kidney Dis 1990;15:265-8. https://doi.org/10.1016/s0272-6386(12)80772-4
  2. Abu-El-Haija B, Bhave PD, Campbell DN, Mazur A, Hodgson-Zingman DM, Cotarlan V, et al. Venous stenosis after transvenous lead placement: a study of outcomes and risk factors in 212 consecutive patients. J Am Heart Assoc 2015;4:e001878. https://doi.org/10.1161/JAHA.115.001878
  3. Bakhshoude B, Ravari H, Kazemzadeh GH, Rad MP. Diagnostic value of computerized tomography venography in detecting stenosis and occlusion of subclavian vein and superior vena in chronic renal failure patients. Electron Physician 2016;8:2781-6. https://doi.org/10.19082/2781
  4. Gentile A, Petit L, Masson F, Cottenceau V, Bertrand-Barat J, Freyburger G, et al. Subclavian central venous catheter-related thrombosis in trauma patients: incidence, risk factors and influence of polyurethane type. Crit Care 2013;17:R103. https://doi.org/10.1186/cc12748
  5. Hill JM, McGuire MH, Crosby LA. Closed treatment of displaced middle-third fractures of the clavicle gives poor results. J Bone Joint Surg Br 1997;79:537-9. https://doi.org/10.1302/0301-620X.79B4.0790537
  6. Assenza M, Centonze L, Valesini L, Campana G, Corona M, Modini C. Traumatic subclavian arterial rupture: a case report and review of literature. World J Emerg Surg 2012;7:18. https://doi.org/10.1186/1749-7922-7-18
  7. Kihlstrom C, Moller M, Lonn K, Wolf O. Clavicle fractures: epidemiology, classification and treatment of 2 422 fractures in the Swedish Fracture Register; an observational study. BMC Musculoskelet Disord 2017;18:82. https://doi.org/10.1186/s12891-017-1444-1
  8. Cooney DR, Kloss B. Case report: delayed subclavian vein injury secondary to clavicular malunion. J Emerg Med 2012;43:648-50. https://doi.org/10.1016/j.jemermed.2010.05.022
  9. Akyuz M, Gokalp O, Ozcem B, Ozcan S, Besir Y, Gurbuz A. Surgical management of axillosubclavian vascular injuries. Pak J Med Sci 2015;31:552-5. https://doi.org/10.12669/pjms.313.7316
  10. Giannakopoulos TG, Avgerinos ED. Management of peripheral and truncal venous injuries. Front Surg 2017;4:46. https://doi.org/10.3389/fsurg.2017.00046
  11. Wright SW. Subclavian vein thrombosis following clavicular fracture. Emerg Med J 2009;26:840. https://doi.org/10.1136/emj.2008.070318
  12. Dhakal P, Gundabolu K, Bhatt VR. An algorithmic approach to management of venous thromboembolism. Clin Appl Thromb Hemost 2017;23:511-7. https://doi.org/10.1177/1076029616652727
  13. Barrett N, Spencer S, McIvor J, Brown EA. Subclavian stenosis: a major complication of subclavian dialysis catheters. Nephrol Dial Transplant 1988;3:423-5. https://doi.org/10.1093/oxfordjournals.ndt.a091691
  14. Ranke H, Mardian S, Haas NP, Baecker H. Thrombosis of the subclavian vein after conservative treatment of a clavicular fracture: a rare complication. Unfallchirurg 2016;119:255-8. https://doi.org/10.1007/s00113-015-0091-y
  15. Ropars M, Thomazeau H, Huten D. Clavicle fractures. Orthop Traumatol Surg Res 2017;103:S53-9. https://doi.org/10.1016/j.otsr.2016.11.007