ArticleBMC surgery2026
Traumatic brachial artery reconstruction using an in-wound no-touch superficial vein graft with 20-month imaging follow-up: a case report.
Article in BMC surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundAutologous vein grafting is commonly used for traumatic limb arterial defects when tension-free primary repair is not possible. The no-touch harvest technique has shown structural and patency advantages in coronary surgery, but its role in traumatic upper-extremity reconstruction remains uncertain. CASE PRESENTATION: A 63-year-old man sustained an open right elbow injury caused by a fan blade, with brachial artery transection, superficial venous injury, lateral antebrachial cutaneous nerve injury, and superficial brachioradialis laceration. After microscopic debridement, the arterial defect between viable ends measured about 5.5 cm. A median cubital vein within the wound was selected as an interposition conduit because an adequate segment remained outside the most severely damaged zone, the wall appeared continuous without visible thrombosis or crush injury, and the caliber matched the brachial artery. The vein was harvested with a limited cuff of surrounding tissue using a no-touch concept, reversed, and anastomosed end-to-end under the microscope. The patient received intraoperative heparin and short-term postoperative low-molecular-weight heparin, but no long-term oral antithrombotic therapy because of individualized bleeding-risk and wound considerations. At 20 months, duplex ultrasonography and computed tomography angiography showed sustained graft patency, preserved distal runoff, and mild ectatic change without hemodynamically significant stenosis, occlusion, or pseudoaneurysm.
conclusionsThis case supports technical feasibility rather than superiority in selected traumatic brachial artery injuries. An in-wound superficial vein may be usable when a structurally intact segment remains available outside the most severely injured zone. The no-touch concept was technically applicable in this setting, but its clinical benefit in peripheral trauma remains unproven.
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