Department of CVTS, Grant Government Medical College, IndiaFulltext PDF
Injuries to the subclavian artery as well as post traumatic pseudoaneurysm of the Subclavian Artery (SCA) are uncommon. We performed retrospective study of ten patients for strategies of management of subclavian artery pseudoaneurysm enrolled in the study from March 2013 to January 2022 at Grant medical college and JJ group of Hospitals, Mumbai (Maharashtra). All patients enrolled in the study were male with age range between 20 to 40 years. Three patients had left sided and seven patients had right sided subclavian artery involvement. Eight of the patients had traumatic history of subclavian artery injury out of which five patients had history of penetrating stab injury, two patients had blunt injury, and one patient had stone chip injury. Two patients had iatrogenic history while central line insertion. All patients underwent computed tomography angiography preoperatively and postoperative Doppler study. All patients underwent emergency operative procedure after short preoperative workup. Pseudoaneurysm excision with repair of subclavian artery was done in all patients. Primary repair of Subclavian artery done in 4 patients and repair of artery with vein patch in 2 patients. Interposition graft with reverse saphenous vein graft for 2 patient and PTFE in 2 patients. Subclavian vein injury was there in two patients which were managed with primary repair. One patient had brachial plexus injury which was managed by plastic surgeons. On follow-up Doppler study done after 6 month of surgery, normal study was noted. One patient had wound gaping which was treated with dressing and secondary suturing. There were no deaths. Good results can be achieved by emergent management to prevent complications such as rupture, infection, gangrene. Proximal and distal control of artery is a must for safe excision of any pseudoaneurysm. Stenting of subclavian artery pseudoaneurysm is good option but with the risk of infection and abscess formation in residual Pseudoaneurysm, surgical excision is the best option for large pseudoaneurysm.
Subclavian artery injury; Pseudoaneurysm; Computed tomography angiography
Jaiswal D. Management of Subclavian Artery Pseudoaneurysm: Case Series. World J Vasc Surg. 2022;5(1):1032..