Chronic traumatic pseudoaneurysm of right subclavian artery

Bechini, Jordi; Cuadras, Patricia; Tenesa, Montserrat; Lisbona, C.; Casas, D.; Olazabal, Ainhoa Alonso

doi:10.1007/s003300050340

Cited by 12 publications

(7 citation statements)

References 6 publications

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“…Injury to the subclavian artery following blunt trauma is uncommon and accounts for only 2% to 3% of all reported subclavian artery injuries. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17] Penetrating trauma of the subclavian artery is at least 50 times more common. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18] The largest published series of subclavian artery injuries includes 93 cases of which only two were secondary to blunt trauma.3 This relatively low incidence of blunt subclavian artery injury has been attributed to the protection conferred by its anatomic location within the shoulder girdle.3'8 '12-14 Two theoretical mechanisms for blunt subclavian artery injury have been proposed.…”

Section: Discussionmentioning

confidence: 99%

Subclavian Arterial Injury Associated with Blunt Trauma

Katras

Baltazar²,

Rush

et al. 2001

Vascular Surgery

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Blunt subclavian artery trauma is an uncommon but challenging surgical problem. The purpose of this study was to retrospectively review the management of blunt subclavian artery injuries treated by the Trauma and Vascular Surgery Services at the East Tennessee State University-affiliated hospitals between 1992 and 1998. Six patients with seven blunt subclavian artery injuries were identified. Physical signs indicating blunt subclavian artery injury were pain or contusion around the shoulder joint; fractures of the clavicle, scapula, or ribs; periclavicular hematomas; and ipsilateral pulse or neurologic deficits. Seven subclavian artery injuries were treated-two arterial transections, two pseudoaneurysms, and three intimal dissections. Associated injuries included four clavicle fractures, one humerus fracture, one combined rib and scapular fractures, and two pneumothoraxes. Vascular surgical treatment included three primary arterial repairs, two saphenous vein interposition grafts, and one polytetrafluoroethylene (PTFE) graft. One patient was treated nonoperatively with anticoagulation. No deaths occurred. Morbidity occurred in two patients with chronic upper extremity neuropathy producing prolonged disability from pain and weakness; one patient had reflex sympathetic dystrophy, and the other had a brachial plexus injury. In conclusion, blunt subclavian artery trauma can be successfully managed with early use of arteriography and prompt surgical correction by a variety of vascular techniques. Vascular morbidity is usually low, but long-term disability because of chronic neuropathy may result from associated brachial plexus nerve injury despite a successful arterial repair.

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Section: Discussionmentioning

confidence: 99%

Subclavian Arterial Injury Associated with Blunt Trauma

Katras

Baltazar²,

Rush

et al. 2001

Vascular Surgery

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“…10 A pseudoaneurysm can produce symptoms such as dyspnea, dysphagia, upper limb edema, and upper limb ischemia by compression of the surrounding tissues, and can cause life- threatening massive hemorrhage in case of rupture of the pseudoaneurysm. 6,11 It can also be asymptomatic, occurring in weeks to years after the trauma, averaging about 5 years. 11 In our case series, the shortest time from trauma to the discovery of SAP was 6 months and the longest time was 5 years, which is consistent with the reports above.…”

Section: Discussionmentioning

confidence: 99%

Endovascular Treatment of Subclavian Artery Pseudoaneurysm

Wang¹,

Dong²,

Liang³

et al. 2020

Annals of Vascular Surgery

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Background: In recent years, endovascular treatment of subclavian artery pseudoaneurysm (SAP) has been recommended by many experts. The aim of this study is to evaluate the safety and efficacy of the endovascular treatment of SAP, and to introduce our experience in the diagnosis and treatment of SAP. Methods: A total of 8 consecutive patients with SAP were treated with endovascular treatment in our hospital between 2010 and 2018. We retrospectively reviewed the patients' clinical characteristics, physical examinations findings, diagnostic imaging results, endovascular treatment, clinical outcome, and follow-up results. Results: All the 8 patients received endovascular treatment with covered stents initially. The technical success rate was 87.5% (7/8). In 1 patient with severe tortuosity of the proximal subclavian artery, the stent could not be released through the femoral artery approach in the primary operation but was successfully released via the brachial artery approach in the secondary operation. No complications occurred in the perioperative period. All the symptoms and signs were significantly relieved. During a follow-up of 4.5e84.5 months (average 31.5 months), 1 patient developed an endoleak 4 months after operation and reintervention was attempted but failed. No adverse events occurred in other patients during the follow-up period. Conclusions: Endovascular treatment of SAP is safe and effective, and should be used as a first-line treatment. Stent placement through the brachial artery approach is recommended for SAP with severe proximal vascular tortuosity.

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“…Blunt injuries cause mostly aneurysm or pseudoaneurysm and are usually associated with musculoskeletal or brachial plexus injury. 2 Combined pseudoaneurysm and AV fistula of subclavian artery and vein and its surgical management has been rarely reported in literature.…”

Section: Discussionmentioning

confidence: 99%

Late Concomitant Pseudoaneurysm and Arteriovenous Fistula of the Subclavian Artery: A Developing Country Perspective

Fatimi

Deedar-Ali-Khawaja

Niazi

et al. 2010

Vasc Endovascular Surg

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Concomitant subclavian artery pseudoaneurysm and arteriovenous (AV) fistula has been rarely reported. We report a case of late concomitant pseudoaneurysm and AV fistula of the subclavian artery caused by a gunshot wound. Open surgical approach with an infraclavicular approach was used; subclavian artery was repaired with a Gortex interposition graft and subclavian vein was ligated. The postoperative course was uneventful. In developing countries, where the endovascular expertise is unavailable or if the lesion is large, open surgical approach provides similar results as an endovascular approach.

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Chronic traumatic pseudoaneurysm of right subclavian artery

Abstract: A right subclavian artery pseudoaneurysm caused by blunt trauma is described. CT and digital subtraction angiography helped us to establish a correct diagnosis. Radiologic features of subclavian artery aneurysms and relevant literature are briefly discussed.

Cited by 12 publications

References 6 publications

Subclavian Arterial Injury Associated with Blunt Trauma

Subclavian Arterial Injury Associated with Blunt Trauma

Endovascular Treatment of Subclavian Artery Pseudoaneurysm

Late Concomitant Pseudoaneurysm and Arteriovenous Fistula of the Subclavian Artery: A Developing Country Perspective

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