Risk of continuing planned surgery after endovascular repair of subclavian artery injury: a case report

Abstract

Endovascular repair with covered stents has been widely used to treat subclavian and axillary artery injuries and has produced promising early results. The possibility of a thromboembolism occurring in cerebral arteries during an endovascular procedure should be a cause for concern. In the case of endovascular management of arterial traumas, a prompt and sufficient period for check-up of the patient's neurological signs is needed, even if it requires postponing elective intervention for the patient's safety. We report a rare case of liver transplantation immediately after endovascular repair of an iatrogenic subclavian arterial injury to describe the risk of continuing planned surgery without neurologic assessment.

Towards Optimal Central Venous Catheter Tip Position

“…The present data demonstrate that with catheter 7F and over, the pull/pressure technique could be associated with significantly higher morbidity than surgical or endovascular management, including stroke, suddenly expanding hematoma causing airway compression, false aneurysm, or death [20][21][22]. Under no circumstances should prolonged arterial cannulation be tolerated [20].…”

“…After arterial repair, prompt neurological evaluation should be performed, even if it requires postponing elective intervention [20][21][22]. Imaging is suggested to exclude arterial complications, especially if arterial trauma site was not examined and repaired [20].…”

“…If arterial trauma with a large-caliber catheter occurs, prompt surgical or endovascular treatment seems to be the safest approach [20]. After arterial repair, prompt neurological evaluation should be performed, even if it requires postponing elective intervention [20][21][22].…”