Osteochondroma of the scapula associated with a subclavian artery pseudoaneurysm: Case report

Abstract

Osteochondromas rarely induce vascular complications by mechanical compression. We present the case of a subclavian artery pseudoaneursym caused by an osteochondroma of the scapula in a 67-year-old male. The diagnosis was based on a previous history of multiple exostoses, computed tomography and magnetic resonance imaging, as well as the local vascular clinical status of the lesion. Surgical treatment consisted of vascular and orthopaedic intervention. First, the vascular surgeon implanted a bypass of the subclavian artery from the ventral aspect, enabling the orthopaedic surgeon to resect the osteochondroma from the dorsal aspect. The patient recovered with full function. Vascular pseundoaneurysms should be taken into consideration in patients with osteochondromas, especially with a known history of multiple hereditary exostoses.

Popliteal artery pseudoaneurysms in patients affected by osteochondroma

“…In particular, brachial pseudoaneurysms were reported in seven cases, while the subclavian artery was involved in one case. 9 As described in Table 1, the typical clinical presentation was a painful, pulsatile and expansive mass at the region of the pseudoaneurysm (in most cases the popliteal fossa or the distal third of the thigh), which was sometimes associated with swelling of the involved limb. Usually the mass had a slow growth over weeks or months.…”

“…In particular, brachial pseudoaneurysms were reported in seven cases, while the subclavian artery was involved in one case. 9 …”

Fractured osteochondroma presenting with popliteal pseudoaneurysm: Case report and review of literature

“…Nonetheless, pseudoaneurysms of the subclavian, brachial, superficial femoral, medial femoral circumflex, and posterior tibial arteries have also been described. [8][9][10][11][12] The popliteal artery is often injured because of the increased frequency of osteochondromas in the distal femur. Furthermore, the limited mobility of the artery at the proximal adductor canal may facilitate tethering to the osteochondroma.…”

Open Surgical Approach for Type II Endoleak in Subclavian Artery Pseudoaneurysm Presented With Neurological Symptoms After Endovascular Repair

“…The contemporary reports describe treatment approaches using covered stents to exclude the pseudoaneurysm of subclavian-axillary artery [4][5][6][7] and open surgical techniques to bypass, exclude the pseudoaneurysm or repair the arterial injury site. [8][9][10] Clavicle fracture, as a rare cause of subclavian artery pseudoaneurysm formation, was first reported in 1931; however, there have been few reports since then. 11 Early complications have been described with patients presenting within months of a clavicular fracture with a pulsatile mass and hand ischemia.…”

“…The contemporary reports describe treatment approaches using covered stents to exclude the pseudoaneurysm of subclavian–axillary artery 4 -7 and open surgical techniques to bypass, exclude the pseudoaneurysm or repair the arterial injury site. 8 –10…”