Which Graft must be Preferred in Firearm Injury of the Axillary Artery

Abstract

Aims: Interposition graft technique is used mostly in firearm wounds of axillary artery, because of excessive defect of the vessel. Autologous vein has been preferred in general application, even though there is a mild size discrepancy between native artery and autologous vein. However, in many series, prosthetic graft infection risk has been reported as low. Presentation of Case: I am presenting a patient with a gunshot wound to the right upper chest. As a first choice I preferred saphenous vein which was occluded by thrombosis at the post-repair third week in spite of anticoagulant therapy and was replaced with prosthetic graft which was patent at the eight month follow-up. Discussion: Although the theoretical risk of infection of prosthetic grafts, many previous reports have demonstrated that prosthetic grafts are nearly as safe as autologous grafts and they have high long-term patency rate. Conclusion: There is no point in insisting on autologous grafts in cases of the diameter discrepancy between native artery and autologous graft, prosthetic graft may be used more frequently in axillary artery trauma, and post-repair anticoagulants may be administered in the consequences of size discrepancy between the native artery and the graft.