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August 1978

A Method for Rapid Identification of Distal Arterial Tree in Massive Soft-Tissue Injury

Arch Surg. 1978;113(8):1015. doi:10.1001/archsurg.1978.01370200109026

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Vessel retraction following arterial transection is not a frequent problem. When complete transection occurs, muscular branches from its proximal and distal ends prevent retraction. Occasionally, in massive soft-tissue injury, the muscular branches are also severed, contributing to its retraction. In such cases, pulsation and active bleeding from the transected proximal end make it easy to identify, while identification of retracted distal end in injured muscle mass and hematoma poses a problem. Recently, we solved a problem of locating the retracted distal end by retrograde catheterization as described below.

Report of a Case.—A 30-year-old man was admitted with a gunshot wound of the right shoulder that resulted in complete transection of the subclavian artery with disruption of the axillary and distal subclavian artery, vein, and massive contusion of the pectoral muscles. On exploration there was difficulty in finding the distal end, which has retracted into hematoma and contused muscles. The

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