Endovascular repair of the left subclavian artery after gunshot wound: an alternative to surgical treatment

Abstract

Penetrating injuries of the subclavian artery are associated with a high morbidity and mortality rate. Endovascular treatment with covered stents (stent grafts) has emerged as an eff ective alternative to surgery, but this new technique is not exempt from complications. We report the case of a male gunshot victim, treated by a covered stent for haemorrhagic shock due to partial subclavian rupture.

Tratamento endovascular de fístula traumática de vasos subclávios: relato de caso

“…Traumatic injuries of the subclavian arteries are uncommon, but are associated with elevated morbidity and mortality rates. [2][3][4] Penetrating traumas are the most common causes. 3 Incidence ranges from 2.3% to 3.9%.…”

“…[2][3][4] Penetrating traumas are the most common causes. 3 Incidence ranges from 2.3% to 3.9%. [4][5][6] In a review of 262 cases of traumatic fistulas, Rich et al 6 found one case of fistula of subclavian vessels.…”

“…6 Open surgery to treat traumatic lesions of the subclavian vessels can be a challenge because of their proximity to highly important neurovascular structures, in addition to presence of edema, hematoma, and anatomic changes caused by the trauma. 7 Postoperative mortality ranges from 5 to 40%, 3,4,8 and postoperative complications can reach 24%. 3 Endovascular treatment is a safe and effective alternative to open surgery.…”

“…7 Postoperative mortality ranges from 5 to 40%, 3,4,8 and postoperative complications can reach 24%. 3 Endovascular treatment is a safe and effective alternative to open surgery. 9 Morbidity and mortality are in the range of 5 to 10% among patients treated using endovascular methods.…”

“…9 Morbidity and mortality are in the range of 5 to 10% among patients treated using endovascular methods. 3,5 Endovascular surgery is possible in about 50% of cases of traumatic subclavian artery injury. [10][11][12] Endovascular treatment can be used for intimal injuries, dissection, fistulas, and pseudoaneurysms.…”