Injury to the Axillo-Brachial artery in a violent act (Axe)
Vascular injuries are commonly seen in road side accidents. Few cases of vascular injuries are treated at NIMS are due to domestic violence at home with sharp, heavy and blunt objects. Usually axillary artery is well protected and so it is rarely injured. Today we repaired axillary artery in young man after axe-injury. Vein graft was needed to bridge the gap. This patient was initially treated with ligation of the injured axillary artery by the local doctors who later referred him to our center for the definitive repair. There was also injury to the median nerve which required plastic surgical repair. Post operatively doppler signals are normal.

Reference
Aust N Z J Surg. 1995 May;65(5):327-30.
Penetrating injuries of the axillary artery.

Degiannis E, Levy RD, Potokar T, Saadia R.
Department of Surgery, Baragwanath Hospital, University of Witwatersrand Medical School, Johannesburg, Republic of South Africa.
Abstract

This is a retrospective study of 32 patients with penetrating injury of the axillary artery. There was an overall mortality of 6% entirely accounted for by associated injuries. Pre-operative angiography was used in 12 of these patients either to confirm the presence of an injury or to define its location. Twelve patients underwent lateral arteriorrhaphy or an end-to-end anastomosis and 19 patients had an interposition graft. No immediate problems were experienced with polytetrafluoroethylene grafts compared with autogenous vein grafts. There were 14 patients with a concomitant venous injury; 13 were repaired and only transient arm oedema was experienced. Eleven patients had a brachial plexus injury and, of these, nine underwent a secondary nerve repair with a poor outcome. Axillary artery injury has a good prognosis with a morbidity related mainly to associated nerve injury and a mortality accounted for by injuries to other body systems.