Subclavian Artery Transection Due to Blunt Trauma

An adult male patient with intrathoracic left subclavian artery transection and thrombosis secondary to blunt trauma is presented. There was a delay in diagnosis of 36 hours because initially there were few physical or radiologic signs ordinarily associated with thoracic vascular injury. Aortography was per formed because of sudden hemothorax and left supraclavicular swelling. Suc cessful repair was performed with autogenous saphenous vein. A high degree of clinical suspicion is necessary to detect subclavian transection from blunt trauma because of the location of this injury, lack of initial bleeding, and the rich collateral blood supply to the arm.