Endovascular Management of Suprascapular Artery Pseudoaneurysm

Abstract

Pseudoaneurysms can be debilitating for patients and occasionally life threatening. Many imaging modalities may be used to assess and define these vascular lesions, and various methods have been employed in their treatment. Our patient suffered trauma to his left shoulder resulting in fracture of his clavicle following an automobile accident and subsequently was found to have a pseudoaneurysm of his left suprascapular artery on imaging. This was treated by transarterial embolization, which resulted in immediate relief of his symptoms. Endoluminal management offers a safe and effective way of treating these lesions.

Traumatic Pseudoaneurysm of the Ascending Cervical Artery Treated with N-butyl Cyanoacrylate Embolization: A Case Report and Review of the Literature

“…Evaluation of a suspected pseudoaneurysm or AVFs may be performed with CTA, which carries a sensitivity and specificity of more than 95% [4]. Duplex sonography has also been shown to provide similar reliability to CTA and MRA (magnetic resonance angiography), but spatial resolution and details of the associated vasculature are limited [5]. Digital subtraction angiography is considered the gold standard and provides vital information regarding collateral vascularization and thyrocervical trunk anastomoses to important neurologic structures.…”

“…Treatment of thyrocervical trunk pseudoaneurysms and AVFs has classically been approached through open surgical repair, but this is associated with significant morbidity and mortality, longer recovery, and higher costs [5]. Ultrasound-guided compression and thrombin injection are new alternatives for the treatment of superficial pseudoaneurysms.…”

“…Endovascular treatments have emerged, providing reduced recovery time, lower cost, and decrease in operative morbidity [5]. This modality is applied with the goal of separating the pseudoaneurysm from its circulation and has been successfully described in the thyrocervical trunk using detachable coils [2,5].…”

“…Endovascular treatments have emerged, providing reduced recovery time, lower cost, and decrease in operative morbidity [5]. This modality is applied with the goal of separating the pseudoaneurysm from its circulation and has been successfully described in the thyrocervical trunk using detachable coils [2,5]. Pseudoaneurysms in other areas of the vasculature have been treated with other endovascular methods such as with flow-diverting stents [7], Onyx [8], and NBCA [9].…”

Suprascapular artery pseudoaneurysm

“…Although there are no case reports of suprascapular artery pseudoaneurysm rupture, it remains a potentially life threatening consequence . Several recent case reports demonstrate successful selective endovascular embolization of selected thyrocervical trunk arterial branches with either microcoils, liquid polymer or ultrasound‐guided thrombin injection . Long‐term outcomes, however, remain unknown.…”