Elective and emergent endovascular treatment of subclavian artery aneurysms and injuries.

Abstract

PURPOSE:

To demonstrate our short and long-term results after transbrachial treatment of subclavian artery aneurysms and injuries with stent-grafts in elective and emergency settings.

METHODS:

Ten of 12 consecutive patients (6 men; mean age 63.8 years, range 38-80) were treated electively with commercially prepared endografts delivered via a transbrachial access to repair a subclavian artery aneurysm (n=3) or an injury from a misplaced central venous catheter (n=7). Two patients required emergency treatment for a ruptured atherosclerotic aneurysm in one and an unintentional arterial puncture during placement of a central venous access in the other. Stent-graft patency during follow-up was assessed by physical examination with comparison of brachial blood pressures in all patients; computed tomography angiography (CTA) was performed in available patients.

RESULTS:

Successful deployment of stent-grafts with sealing of the lesion was achieved in all cases. There were 2 (17%) procedural complications. One patient developed an access-site hematoma that required surgical revision. The second patient, who had a right subclavian injury, suffered an embolic cerebral infarction. The primary stent-graft patency during follow-up (mean 11.6 months) was 100%. CTA examinations in 7 patients at a mean 18 months showed strut dislocation at the thoracic outlet without luminal narrowing in 1 patient. A 50% intraluminal narrowing due to compression between the clavicle and the first rib occurred in another patient. Six patients with a mean follow-up of 23 months (range 0.3-4.5 years) are still alive with patent stent-grafts.

CONCLUSIONS:

Endovascular stent-graft treatment of subclavian artery aneurysms and injuries is a less invasive alternative to surgical repair. Long-term results must still be confirmed in further studies.

• Authors: Maria Schoder, Manfred Cejna, Thomas Hölzenbein, Georg Bischof, Fritz Lomoschitz, Martin Funovics, Iris Nöbauer-Huhmann, Irene Sulzbacher, Johannes Lammer
• Journal: Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists (J Endovasc Ther) Vol. 10 Issue 1 Pg. 58-65 (Feb 2003) ISSN: 1526-6028 [Print] United States
• PMID: 12751932 (Publication Type: Journal Article)

Topics

• Adult
• Aged
• Aged, 80 and over
• Aneurysm (diagnostic imaging, etiology, surgery)
• Angiography
• Blood Vessel Prosthesis Implantation
• Catheterization, Central Venous (adverse effects)
• Elective Surgical Procedures
• Emergencies
• Female
• Humans
• Male
• Middle Aged
• Stents
• Subclavian Artery (diagnostic imaging, injuries, surgery)
• Treatment Outcome