TẮC ĐỘNG MẠCH NÁCH Ở BỆNH NHÂN SỬ DỤNG NẠNG SAU CẮT CỤT CHI DƯỚI: BÁO CÁO 3 TRƯỜNG HỢP

Abstract

Background: Axillary artery occlusion is an uncommon vascular condition, most often related to trauma or iatrogenic injury. In patients with lower limb amputation who rely on long-term crutch use, prolonged axillary compression may cause endothelial injury, thrombosis, and upper limb ischemia, which is frequently overlooked or misdiagnosed. Objectives: To describe the clinical presentation, diagnostic approach, surgical management, and outcomes of three patients with axillary artery occlusion associated with prolonged crutch use after lower limb amputation. Methods: We report a case series of three patients with a history of lower limb amputation and long-term crutch use who presented with symptoms of upper limb ischemia. All patients underwent clinical examination, duplex ultrasound, and computed tomography angiography or digital subtraction angiography to determine the extent of vascular lesions. Surgical revascularization was performed in all cases. Results: All three patients demonstrated long-segment occlusion of the axillary–brachial artery. Thrombectomy combined with reversed autologous great saphenous vein bypass from the axillary artery to the brachial artery was successfully performed. Postoperatively, arterial flow was restored, the affected limbs became warm, and pain, numbness, and motor weakness markedly improved. No major complications or early re-occlusion were observed during follow-up. Conclusions: Axillary artery occlusion due to prolonged crutch-related compression is a rare but important cause of upper limb ischemia in patients with lower limb amputation. Early recognition, appropriate imaging, and timely surgical revascularization are crucial for limb salvage and functional recovery. Proper education on correct crutch use is essential to prevent this complication.