Case ReportsTransluminal placement of a prosthetic graft-stent device for treatment of subclavian artery aneurysm*
Section snippets
Case report
A 78-year-old male patient required total parenteral nutrition because of pyloric obstruction. The initial attempt to gain vascular access for total parenteral nutrition was via the right subclavian vein. This was unsuccessful. A subsequent attempt to place a line in the left subclavian vein was successful. One week later it was noted that an expansile pulsation was present in the right supraclavicular fossa. A decision was made to keep the patient under observation rather than operate on the
Discussion
The treatment options for this patient were conservative observation, open operation, or endovascular repair. Conservative management involved considerable risk in view of the size of the aneurysm, its observed increase in size, and the geographic isolation of the patient from a specialized vascular service. Open operation on the subclavian artery may be approached through a supraclavicular incision or by thoracotomy. In this case, control of the proximal subclavian artery could be obtained
References (11)
- et al.
Transfemoral placement of intraluminal polyurethane prosthesis for abdominal aortic aneurysm
J Surg Res
(1986) - et al.
Transfemoral intraluminal graft implantation for abdominal aortic aneurysms
Ann Vasc Surg
(1991) - et al.
Percutaneous placement of a balloon-expandable intraluminal graft for life threatening subclavian arterial hemorrhage
J Vasc Interv Radiol
(1991) Transluminally placed coil spring endarterial tube grafts: long term patency in canine popliteal artery
Invest Radiol
(1969)- et al.
Percutaneous endovascular graft: experimental evaluation
Radiology
(1987)
Cited by (144)
Stenting of Subclavian Artery True and False Aneurysms: A Systematic Review
2018, Annals of Vascular SurgeryCitation Excerpt :Development of higher quality imaging technology over the last decades has played a key role in the diagnosis of SA aneurysms. In our analysis, approximately, 25% of the included studies used more than 1 imaging method to reach diagnosis.6,9,19,28,30,42,45,50,51,53,56,61,62,66,71,74 No case series reported on the exclusive use of X-ray, with the latter being useful in setting the working diagnosis that was later confirmed by either CTA or DSA.
Subclavian Artery Disease: Diagnosis and Therapy
2017, American Journal of MedicinePrimer in Cerebrovascular Disease: Innominate and Subclavian Disease
2017, Primer on Cerebrovascular Diseases: Second EditionManagement of iatrogenic subclavian artery pseudoaneurysms
2015, Annals of Vascular SurgeryCitation Excerpt :This approach may be required in large pseudoaneurysms located at the proximal third of the SA. Based on these difficulties and the invasiveness of the open procedure, several authors have advocated an endovascular approach, including ultrasound-guided thrombin injection, coiling, or stent grafting as being less morbid and of lower risk.4,5 When treating an iatrogenic SAP with ultrasound-guided thrombin injection, the location of the artery in the clavicular region often makes the pseudoaneurysm approach difficult, raising the risk of trauma of important adjacent structures during needle insertion.6
Endovascular treatment of ruptured subclavian artery aneurysm presented with hemoptysis
2015, Journal of Cardiology CasesChanging profiles of diagnostic and treatment options in subclavian artery aneurysms
2010, European Journal of Vascular and Endovascular Surgery
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Reprint requests: Professor James May, Department of Surgery, University of Sydney, NSW 2006 Australia.