Endovascular Repair of Incidentally Found Subclavian Artery Aneurysm: A Case Report From an Urban Level 1 Trauma Center

Abstract

Subclavian artery aneurysms (SAAs) are historically rare peripheral aneurysm. However, it can be associated with serious life-threatening complications including rupture, thrombosis, and embolism. The majority of such aneurysms are found incidentally. Historically, SAA have been repaired via an open approach. Increasing case reports demonstrate successful management of SAAs with endovascular repair. The present report describes a case of incidentally discovered large proximal saccular subclavian aneurysm with suspected remote traumatic etiology with a successful endovascular repair.

Long-term outcomes of endovascular treatment of isolated subclavian artery aneurysms

“…Although the most common cause of ISAAs was trauma, intrathoracic aneurysms were mostly caused by atherosclerosis and collagen disorders according to previous studies. 3,8 Atherosclerosis was regarded as the main cause of aneurysms in the current series, which concurred with the fact that intrathoracic lesions occupied a greatly larger proportion. Therefore, despite that over 60% of ISAAs were pseudoaneurysms mainly caused by trauma according to published data, 3 it was true aneurysms resulted from atherosclerosis that accounted for the majority (26/35, 74.3%) of cases in our study.…”

“…3 However, previous reports regarding endovascular treatment for ISAAs were extremely limited compared to other peripheral aneurysms such as femoral and popliteal artery aneurysms, [4][5][6] and most of the literature are case reports with a small sample size less than 10. [7][8][9][10][11][12][13][14] Apart from the rarity of ISAAs, another factor contributing to the present situation might be that ISAAs possibly involving the vertebral and right carotid arteries make endovascular interventions more sophisticated and challenging than aneurysms located in the lower limbs. No single-center series to date has specifically summarized and assessed endovascular techniques for the exclusion of ISAAs.…”

Successful Balloon-assisted Coil Embolization of Right Subclavian Artery Aneurysm: A Case Report

“…[2][3][4] Reports on subclavian artery aneurysms after 2018 are shown in Table 1. 3,[13][14][15][16][17][18][19][20][21][22] Treatment methods consisted of open surgery in 25 patients, endovascular treatment in 13, and their combination in 3. Endovascular treatment procedures consisted of stent grafting in 12 patients, stenting in 2, stent-assisted coil embolization in 1, and coil embolization in 1.…”

A case report of a ruptured subclavian artery aneurysm presenting to the emergency department

“…Symptoms secondary to distal embolization were infrequent. On the other hand, extrathoracic aneurysms most commonly present with a tender pulsatile mass in the superior fossa as well as pain and neurological dysfunction secondary to brachial plexus compression . Furthermore, proximal SAAs appear more likely to rupture .…”

“…Furthermore, proximal SAAs appear more likely to rupture . Aneurysms are typically diagnosed by CT angiography, which is also crucial in detailing the extent of the aneurysm, the competency of the contralateral vertebral circulation, and to assess anatomic suitability for endovascular repair . It is also useful to note that plain films have been able to reveal superior mediastinal masses that may/suggest a neoplastic process.…”