Subclavian Artery Aneurysm Research Articles

Large Right Subclavian Artery Aneurysm Presenting in a Young Patient.

Subclavian artery aneurysms are extremely rare, accounting for less than 1% all of peripheral aneurysms. They are often due to atherosclerosis or thoracic outlet syndrome and present at an average age of 47years. Here, we present an incidental finding of an 18mm rapidly increasing aneurysm involving the first and second part of the right subclavian artery in a woman in her 20s. To our knowledge, this is the youngest patient presenting with a right subclavian artery aneurysm who underwent surgical resection of the aneurysm with repair using interposition graft and successful re-implantation of the vertebral artery with antegrade flow. This report highlights the multidisciplinary care between vascular, interventional radiology and cardiothoracic teams at our tertiary hospital due to the complex nature of the aneurysm.

Surgical treatment of subclavian artery aneurysm due to fibromuscular dysplasia

Surgical treatment of subclavian artery aneurysm due to fibromuscular dysplasia

Endovascular treatment of contained ruptured internal thoracic artery aneurysm mimicking a tumor in a patient with neurofibromatosis type 1: a case report

BackgroundAn internal thoracic artery aneurysm (ITAA) is an exceedingly rare condition, with approximately two-thirds of reported cases being iatrogenic pseudoaneurysms. The remainder are attributed to various causes, including vasculitis, connective tissue disease, and neurofibromatosis type 1 (NF-1). NF-1 is an autosomal dominant disorder characterized by distinct clinical manifestations that occasionally include life-threatening vascular complications. Although NF-1 patients may develop various vascular abnormalities, ruptured ITAA is rarely reported, with only seven published cases.Case presentationA 32-year-old man with NF-1 consulted for a three-day history of persistent left back and upper arm pain. Initial chest radiography indicated left pleural effusion and an opacity at the left lung apex. Computed tomography scan revealed a mass in the left upper mediastinum that was initially suspected to be a tumor. Subsequent contrast-enhanced computed tomography revealed the mass to be a subclavian artery aneurysm. Detailed contrast-enhanced computed tomography with 1-mm slices was performed for surgical planning, identifying the mass as a left ITAA with contained rupture. Given the risk of re-rupture, emergency angiography was performed, which confirmed rupture of the left ITAA without extravasation. The ITAA was successfully treated with multiple microcoils at the proximal and distal ends. The patient had an uneventful recovery and was discharged on the fourth postoperative day.ConclusionsThis case highlights the importance of considering vascular lesions in NF-1 patients who present with pleural effusion. It also emphasizes the challenges in diagnosing ITAA and the effectiveness of thin-slice contrast-enhanced computed tomography scans and endovascular treatment.

Supra-sternal reconstruction for a high-hanging fruit like right subclavian artery aneurysm

Supra-sternal reconstruction for a high-hanging fruit like right subclavian artery aneurysm

Single Center Experience in Surgical Treatment of Extracranial Supra-Aortic Aneurysms

Objective To evaluate the effect of surgical treatment on extracranial supra-aortic aneurysms and summarize the experience. Methods The clinical data of 10 patients undergoing surgical treatment of extracranial supra-aortic aneurysms from May 2019 to November 2023 in the Department of Vascular Surgery of Beijing Tiantan Hospital affiliated to Capital Medical University were collected.The 10 patients included 5 patients with internal carotid artery aneurysm,2 patients with subclavian artery aneurysm,2 patients with vertebral artery aneurysm,and 1 patient with internal carotid artery aneurysm combined with ipsilateral subclavian artery aneurysm.The surgical indications,surgical regimens,clinical efficacy,and complications were retrospectively analyzed. Results All the 10 patients underwent surgery successfully,with the surgery duration range of 60-420 min and the median surgery duration of 180.0 (121.5,307.5) min.Intraoperative bleeding volume varied within 30-400 mL,with a median of 90 (50,125) mL.The time of carotid artery blocking and vertebral artery blocking varied within the ranges of 10-20 min and 20-30 min,with the medians of 15.0 (11.5,16.3) min and 25.0 (15.0,22.5) min,respectively.No cardiac accident,cerebral infarction,or cerebral hemorrhage occurred during the perioperative period.The 10 patients were followed up for 3-58 months,with the median follow-up time of 8.5 (5.3,17.0) months.One patient with subclavian artery aneurysm developed artificial vessel occlusion 20 months after surgery.One patient with internal carotid artery aneurysm developed distal carotid artery stenosis 6 months after surgery. Conclusion Surgical treatment should be actively adopted for extracranial supra-aortic aneurysms,and individualized surgical regimens should be designed according to patient conditions.

Institution of cardiopulmonary bypass in an awake patient for resection of isolated intrathoracic right subclavian artery aneurysm causing near total compression of the trachea

Institution of cardiopulmonary bypass in an awake patient for resection of isolated intrathoracic right subclavian artery aneurysm causing near total compression of the trachea

Giant Subclavian Artery Aneurysm

Subclavian artery aneurysms are rare peripheral aneurysms. A giant subclavian artery aneurysm can lead to compression of the trachea or brachial plexus, erosion of the lung causing hemoptysis, hoarseness of voice, dysphagia, Horner’s syndrome, and upper extremity deep vein thrombosis. Compression of the trachea and inability to ventilate the patient can be a real challenge for the anesthesiologist and must be anticipated. Computed tomographic angiography is a useful imaging modality for its diagnosis and to rule out additional aneurysms in the body.

Surgical Outcome of Proximal Isolated Subclavian Artery Aneurysms: A Single-Center Retrospective Observational Study

Objective: The objective of this study was to introduce our institutional experience of treatment strategies (cervical subclavian artery reconstruction, thoracotomy subclavian artery reconstruction and endovascular treatment) for proximal isolated subclavian artery aneurysms (PISAAs). Methods: we retrospectively analyzed 15 consecutive patients with PISAAs treated by different treatment strategies (cervical reconstruction, thoracotomy reconstruction and endovascular treatment) in our institution from May 2016 to May 2022. Baseline data, surgery-related data, postoperative information and long-term follow-up were assessed. Results: A total of 17 PISAAs in 15 consecutive patients were treated in our institution. The success rates of subclavian artery reconstruction in the cervical reconstruction, the thoracotomy reconstruction and the endovascular treatment were 100%, 100 and 83.33%, respectively. About the involved vertebral artery, the reconstruction rates in the cervical reconstruction, the thoracotomy reconstruction, and the endovascular treatment were 80%, 75%, and 0, respectively. The intraoperative blood loss in the thoracotomy reconstruction was significantly higher than that in the cervical reconstruction and the endovascular treatment ( p<0.05). The total operation time of the thoracotomy reconstruction was significantly longer than that of the cervical reconstruction and the endovascular treatment ( p<0.05). In terms of postoperative ventilator use time, total postoperative drainage fluid, total postoperative drainage time, and ICU duration, both the thoracotomy reconstruction and the cervical reconstruction were significantly more than the endovascular treatment ( p<0.05). During the follow-up, one patient in the endovascular treatment underwent re-intervention 22 months after surgery due to in-stent occlusion. Conclusions: For patients with PISAAs, different treatment strategies are recommended depending on the size of the aneurysms and whether the involved vertebral arteries require reconstruction. Clinical impact This article is the largest study on the treatment strategies of PISAAs. By comparing the prognosis and complications of endovascular treatment with those of open surgery, it provides a certain reference basis for the choice of treatment for patients with PISAAs. For patients with aneurysms’ diameter of >50 mm, the thoracotomy subclavian artery reconstruction is recommended; for patients with aneurysms’ diameter of <30 mm requiring reconstruction of the involved vertebral arteries, the cervical subclavian artery reconstruction is recommended; for patients with aneurysms’ diameter of <30 mm not requiring reconstruction of the involved vertebral arteries, the endovascular treatment is recommended.

Right subclavian artery true aneurysm: A rare cause of dyspnea

Subclavian artery aneurysm (SAA) is a rare condition seen in less than 1% of peripheral artery aneurysms. It is usually asymptomatic. However, it may become symptomatic as a result of pressure on the surrounding organs due to the progressive growth of the aneurysm. The standard treatment for SAA is surgery. In this article, we wanted to present a 63-year-old male patient who presented with the complaint of shortness of breath and was operated on with the diagnosis of Right Subclavian artery true aneurysm on thoracic CT angiography.

Endovascular Management for an Aberrant Right Subclavian Aneurysm

Introduction: Aberrant right subclavian artery (ARSA) aneurysm repair is usually performed surgically. Case Presentation: We report the case of an endovascular exclusion of ARSA aneurysm using a degressive covered endograft via axillary access. This technique can avoid classical complications of an open surgical repair and the complexity of hybrid techniques, especially in patients of advanced age with multiple comorbidities.

Endovascular treatment of large posttraumatic false aneurysm of the S2 segment of the subclavian artery: clinical case and literature review

Introduction. Pseudoaneurysms of the subclavian artery are a rare pathology and most frequently occur due to trauma. According to the current literature, subclavian artery aneurysms account for 1 % of all peripheral artery aneurysms. This pathology, although rare, may be accompanied by the risk of rupture, thrombosis, or distal embolism of the arterial lumen. Objective. To demonstrate a clinical case of a patient with successful treatment of subclavian artery pseudoaneurysm by means of modern minimally invasive endovascular technique. Material and methods. The article presents our clinical case with the use of endovascular technique for the treatment of large posttraumatic pseudoaneurysm of the S2 segment of the left subclavian artery using the Bard LifeStream balloon stent graft.Discussion. Currently, direct surgery is considered to be the gold standard of treatment in extracranial aneurysms. Meanwhile, availability of minimally invasive methods allows minimizing the risk by performing endovascular treatment and thus reducing the risk of foreign bodies and infectious complications associated with a large volume of surgical intervention in direct surgery, reducing damage to the brachial plexus, decreasing the number of beddays, and contributing to early rehabilitation measures. The strategy of choice in favor of endovascular treatment should be individual for each patient taking into account such factors as localization, aneurysm size, compression of nearby cranial nerves, and concomitant pathology with high risk of open surgical treatment. Conclusions. Careful selection of patients for endovascular technique will ensure good long-term outcome using all advantages of this technique. At present, it is still relevant and crucial to minimize complications and iatrogenic postoperative lesions in patients with this disease. For this reason, endovascular surgeries should be performed at the stage of specialized medical care by an experienced surgeon.Key words: subclavian artery, false aneurysm, posttraumatic aneurysm, stent graft, endovascular treatment, open surgery, minimally invasive surgery.

Hybrid aortobrachial bypass for a giant subclavian and axillary artery aneurysm in a Marfan patient

Hybrid aortobrachial bypass for a giant subclavian and axillary artery aneurysm in a Marfan patient

Type B interrupted aortic arch with a huge right subclavian artery aneurysm in an adult

Type B interrupted aortic arch with a huge right subclavian artery aneurysm in an adult

Hybrid Aortobrachial Bypass for Giant Subclavian and Axillary Artery Aneurysm in a Patient With Marfan Syndrome

This video demonstrates a challenging case of giant subclavian and axillary artery aneurysm in a patient with Marfan syndrome with multiple prior aortic interventions and coronary artery bypass graft presenting with nerve compression. This patient was successfully treated via a hybrid approach due to complexity. eyJraWQiOiI4ZjUxYWNhY2IzYjhiNjNlNzFlYmIzYWFmYTU5NmZmYyIsImFsZyI6IlJTMjU2In0.eyJzdWIiOiI2M2RkMDAzODFmMmQ3OTliOTkyZTk2MjA0YTEyOTA0MCIsImtpZCI6IjhmNTFhY2FjYjNiOGI2M2U3MWViYjNhYWZhNTk2ZmZjIiwiZXhwIjoxNjg0ODU3NDA5fQ.gqKmrtxKqquiPYJ3OlwGLyE9U2JnnXopV71Vi3ZAv7HO4mzmtelghZoKMPUuzPw0Ci7NSzXaWIiieOBuo3OsvyKQUbrQfajQ2OAZodsglYX9bq_eEwDeG3U3vkqMzRyWxVShNuouWmWl_oboNwSGKzTcAaDtMrGqRCWlYjTLC7s_nxyNxMjkZkrMdpZSElmCHGZFuOGmUhfMZu8rRSAXmNM-7g_dweEe6YOIr43Lm-h1aP5UIVoBwE8s63KveaVuXuIpsTixS57UFvagga0l4dkuQzBNObztfEpKDnPJt1QkUt_S2hgNhHfMUD11cQTJW0yW-ZSpl9iQg0SAsVYStg Download .mp4 (69.55 MB) Help with .mp4 files SUBMISSION 1.10.2023.mp4

Rare Case of Acute Closed Type B Aortic Dissection Complicated by Giant Left Subclavian Artery Aneurysm.

Rare Case of Acute Closed Type B Aortic Dissection Complicated by Giant Left Subclavian Artery Aneurysm.

Physician–Modified Endovascular Graft for Left Subclavian Artery Fenestration during Thoracic Endovascular Aortic Repair

This study aimed to evaluate the safety and efficacy of physician-modified endovascular graft for preservation of left subclavian artery during thoracic endovascular aortic repair. From June 2019 to October 2022, 66 patients with a variety of thoracic aortic pathologies were treated with thoracic endovascular aortic repair using physician-modified endovascular graft left subclavian artery fenestration to achieve adequate proximal landing zone. The details of surgical techniques were described. The perioperative morbidity, mortality, and the outcomes of mid-term follow-up were analyzed. Of the 66 patients (men: women, 53:13; age, 55.18 [55.18±10.62] years), 53 (80.30%) presented with type B aortic dissection, 10 (15.15%) with thoracic penetrating aortic ulcer, 2 (3.03%) with thoracic aortic aneurysm, and 1 (1.52%) with left subclavian artery aneurysm. All of them underwent thoracic endovascular aortic repair using physician-modified endovascular graft left subclavian artery fenestration on the sterile back table. The technique success rate was 96.97% (n=64). Total operation time was 92min (interquartile range, 86-118), graft modification time was 19min (interquartile range, 17-21), fluoroscopy time was 49min (interquartile range, 41-62), and contrast agent dosage was 165mL (interquartile range, 155-185). 30-day perioperative morbidities were 3 (4.55%) strokes, 1 (1.52%) retrograde type A aortic dissection, 1 (1.52%) aortic intimal intussusception, 1 (1.52%) left arm ischemia, and 3 (4.55%) type Ia endoleaks. Postoperative 30-day mortality and reintervention rates were 1.52% and 4.55%, respectively. Among the 63 patients included in the follow-up of 17months (interquartile range, 7.75-18.25), the primary patency of left subclavian artery fenestration stents was 100%. Late complications were 1 (1.59%) distal stent graft-induced new entry and 1 (1.59%) death due to retrograde type A aortic dissection during the follow-up. The stent graft-induced new entry patient was observed with stable false lumen. Thoracic endovascular aortic repair with physician-modified endovascular graft for left subclavian artery revascularization is a safe, feasible, and efficacious technique associated with high success rate. Further study is needed for long-term outcome investigation.

Proximal right subclavian artery aneurysms: A case report and review of the literature.

Subclavian aneurysms are rare in clinic; right subclavian artery aneurysms (SAAs) are more common than left SAAs in clinical practice. Although the causes and methods of treating subclavian aneurysms have been studied, it is still unknown how they form naturally. While describing the uncommon subclavian aneurysm, examine the pertinent literature to discuss its etiology and treatment outcomes, and offer some recommendations for this patient's treatment plan. In this case report, we describe a man patient who had a right subclavian proximal aneurysm that was discovered by accident. No clear clinical symptoms or signs were present in the patient. Upon admittance, an examination revealed an aneurysm in the vertebral artery but no peripheral embolization or compression symptoms. The patient refused operation, so we opted for follow-up instead. The patient took an ultrasound examination at our first follow-up appointment 3months after discharge, and the results showed no thrombosis or appreciable aneurysm enlargement. Follow-up appointments for 6months and a year have begun. Follow-up is a good method to monitor the course of subclavian aneurysms without a clear indication for surgery when there is a clear operation mode and risk.

Mycotic subclavian artery aneurysms: a scoping review.

Mycotic subclavian artery aneurysms (SAAs) are a very rare disorder. To provide an overview of current knowledge on clinical features, management strategies and outcome evaluations of mycotic SAAs. The study materials were based on comprehensive literature retrieval of publications of mycotic SAAs published between 2000 and 2023. Contaminated mechanical injuries and abscess erosions of the arterial walls are mechanisms of mycotic SAAs. The diagnosis relies on detection of pathogenic microorganisms by cultures or microbiological investigations of blood, other fluids and infected tissues as well as medical imaging visualization. The indications for an interventional therapy were poor general condition, high surgical risk, and rescue exclusion for a ruptured pseudoaneurysm. Three (9.1%) pre-treatment deaths were a result of sudden rupture of the mycotic SAAs and thus they lost the opportunity of treatment. All post-treatment deaths occurred in the interventional patient group, whereas the causes of death seemed to be unrelated to mycotic SAAs per se or to treatments of choice. Patient outcome evaluations revealed no significant difference between different treatments of choice. No significant predictive risk factors were responsible for patient outcomes. Once a diagnosis of mycotic SAA is made, sensitive antibacterial drugs are applied immediately to control the infection and control aneurysmal progression. Early treatment is conducted as soon as possible to avoid aneurysmal rupture. A decision on treatment of choice is made based on the patient's specific condition. Antibacterial drug use is continued for about 6 weeks after surgical or interventional therapy.

Surgical treatment of subclavian artery aneurysm

Surgical treatment of subclavian artery aneurysm

A rare phenomenon of spontaneous subclavian artery aneurysm rupture: A care report

Subclavian artery aneurysm (SAA) only occurs in approximately 0.1% of all atherosclerosis aneurysms. Spontaneous rupture of subclavian artery is an extremely rare phenomenon which can lead to mediastinal hematoma and subsequent cardiac death from multiple complications. Proximal and mid clavicular SAAs have higher incidence of rupture. Thrombo-embolic phenomenon is mostly correlated with distal SAA, but it also occurs in <9% of proximal SAA as well. Therapeutic options of SAA repair are open surgical repair or endovascular treatment. We present a case of spontaneous rupture of subclavian artery aneurysm rupture leading to mediastinal hematoma with hypovolemic shock and death.