Brachial artery reconstruction after traumatic disruption.

We describe a series of 21 cases of traumatic disruption of the brachial artery that required surgical intervention. Stab wounds were most frequent (11), followed by gunshot wounds (six) and blunt trauma (four). Ten patients had associated upper extremity injuries including bone, nerve, and vein. Arterial repair with lateral sutures could be accomplished in only one case. Segmental resection of the artery required interposition grafts using autogenous saphenous or cephalic vein in 11 patients. No synthetic graft material was used, and prophylactic antibiotics were given to all patients. All patients are without sequelae a median of 12 months after operation. Complete neurovascular evaluation, including arteriography and venography where indicated, followed by prompt repair is necessary for a successful outcome. The cephalic vein was an excellent alternative for an interposition graft in this series of patients. Primary repair of concomitant injuries, use of perioperative prophylactic antibiotics, and rigid immobilization for a short period followed by active mobilization will yield the best results.