A Case of Iatrogenic Subclavian Artery Injury Successfully Treated with Endovascular Procedures

Abstract

We report a case of a life-threatening massive hemothorax caused by iatrogenic injury of the right subclavian artery. The patient was successfully treated with placement of a covered stent. During the procedure, occlusion balloon catheters rapidly controlled the massive bleeding.

Successful Treatment of Iatrogenic Subclavian Artery Pseudoaneurysm by Ultrasound-Guided Thrombin Injection

“…Endovascular repair might be effective in this situation. 2,3) However, attempts at stenting the subclavian artery could occlude the close right vertebral artery or even lead to cerebral ischemia, especially because our patient's vertebral artery was right-dominant. Therefore, we selected ultrasound-guided thrombin injection, which is less invasive, to treat the subclavian artery pseudoaneurysm.…”

“…In the present case, subclavian artery pseudoaneurysm was successfully treated by thrombin injection; however, if it had failed, another strategy would have been necessary. Options include endovascular repair such as stent-grafting 2) and open surgery. If stenting to the subclavian artery requires coverage of the vertebral artery, a preoperative balloon occlusion test of the vertebral artery can be performed, and if it is positive, reconstruction of the vertebral artery 8) followed by stenting to the subclavian artery is taken into consideration.…”

“…Recent literature has describes less invasive techniques of treating subclavian artery pseudoaneurysms, such as thrombin injection 1) or endovascular repair. 2,3) We report a case of an iatrogenic subclavian artery pseudoaneurysm, which was formed secondary to incorrect central venous catheter insertion, and was successfully treated by ultrasound-guided thrombin injection.…”

Congenital Systemic-Pulmonary Collateral Vein Unexpectedly Noticed after Central Venous Catheter Insertion

“…When a CV catheter is inserted, we should be aware of rare, abnormal anatomy, in addition to complications of puncture, such as pneumothorax and hemothorax. 11) conclusIon This is a rare case of migration of the CV catheter tip into a congenital venous anomaly. To our knowledge, this might be the first report of such a case.…”

Conservative Management in a Young Woman Affected by Isolated Left Subclavian Artery Dissection

“…Endovascular treatment of SAD and others injuries of subclavian artery, with stent placement, 1,13) has proved better than open surgery since burdened by a lower rate of complications. 14) However, a conservative approach with medical therapy alone, has shown excellent outcomes, with cases of spontaneous remission.…”