Arterial and venous injuries in athletes: findings and their effect on diagnosis and treatment.

Abstract

Athletes are susceptible to a variety of vascular injuries, yet clinical presentation may be subtle and the extent of injury underestimated. To evaluate Stanford University's experience with the diagnosis and management of vascular injuries incurred during athletic competition. Between June 1994 and June 2001, 29 patients with athletic competition-related vascular injuries were treated by our service. Clinical presentation, type of athletic competition, location of injury, type of therapy, and degree of rehabilitation were analyzed. Mean patient age was 23.8 years. In total, 17 arterial and 12 venous injuries were treated. Arterial injuries consisted of 8 axillary or subclavian branch artery aneurysms with embolization, 6 popliteal artery injuries, and 3 external iliac artery injuries. Subclavian vein thrombosis (SVT) accounted for all venous complications. Sixteen (94%) patients with arterial injuries required surgical repair. Fifteen reconstructions maintained primary patency with a mean follow-up of 43.9 months. All patients with SVT received lytic therapy and anticoagulation. Eight of these (67%) required thoracic outlet decompression and venolysis. All patients with SVT have remained stable without further venous thrombosis. Athletes are susceptible to vascular injuries that may not be easily recognized. However, a high index of suspicion, appropriate imaging, and prompt treatment allow athletes to return to competition in most cases.