Localized Right Subclavian Artery Dissection Detected by Accident on an Ultrasound Examination: A Case Report and Literature Review

Abstract

Right subclavian artery dissection was detected in a 78-year-old female victim of the Kumamoto earthquake during a carotid artery ultrasound examination. She was subsequently taken to hospital and diagnosed with localized subclavian artery dissection (LSAD) by contrast-enhanced computed tomography. There have been no previous reports of LSAD detected at a medical checkup. LSAD may progress and become severe, even in asymptomatic patients or patients with mild symptoms, and careful long-term follow-up is therefore required in all patients diagnosed with LSAD.

Idiopathic Left Subclavian Artery Dissection

“…The back pain that was described in our case was most likely due to esophageal irritation secondary to NG tube mal-positioning. In the peer-reviewed literature, there has been one other reported case of asymptomatic or mildly symptomatic idiopathic SAD as in our patient [ 1 ].…”

“…SAD without a known cause is quite rare and not well understood [ 1 ]. Although spontaneous or minimally traumatic cases have been documented; most cases are secondary to trauma, connective tissue disease, arterial catheterization or aortic arch anomalies [ 4 , 5 ].…”

“…Although, possible complications such as intramural hemorrhage, false aneurysm, thrombosis or emboli to the head, neck or upper extremity have been reported, the overall prognosis of SAD is favorable [ 1 , 7 ]. The choice of management depends on the presence of any evolution of the false lumen, signs of ischemia or exacerbation of symptoms [ 1 , 5 , 6 ]. Uncomplicated cases have been shown to spontaneously resolve following conservative blood pressure therapy alone as seen in our case present [ 1 , 6 ].…”

“…The choice of management depends on the presence of any evolution of the false lumen, signs of ischemia or exacerbation of symptoms [ 1 , 5 , 6 ]. Uncomplicated cases have been shown to spontaneously resolve following conservative blood pressure therapy alone as seen in our case present [ 1 , 6 ]. Unfortunately, our case was lost to follow-up limiting further monitoring for resolution or progression.…”

“…Unfortunately, our case was lost to follow-up limiting further monitoring for resolution or progression. Heparin and antiplatelet therapy have also been used with good outcomes to manage SADs [ 1 , 4 , 7 ]. When indicated, in those with ischemic symptoms and/or significant comorbid conditions, endovascular stent-graft treatment has also been shown to have good outcomes [ 5 , 7 ].…”