Endovascular management of radiation-induced subclavian and axillary artery aneurysms

Abstract

Subclavian and axillary artery aneurysms are rare occurrences and are associated with serious sequelae if they are untreated. Little is known about these aneurysms, and best practice guidelines are lacking. We describe an 87-year-old man with a history of chest irradiation who presented with radiation-induced subclavian and axillary aneurysms and acute upper extremity ischemia. An endovascular stent graft procedure was undertaken because of his prohibitive high risk for open surgical treatment. Follow-up duplex ultrasound revealed patent stent grafts with complete exclusion of aneurysm sacs. Endovascular therapy is a viable option for upper extremity aneurysms in patients at high risk for open surgical repair.

Hybrid repair of aortic anastomotic aneurysm 40 years after original repair

“…Review of recent literature shows that adults with a new diagnosis of aortic coarctation can be primarily treated with thoracic endovascular aortic repair 4 . Mohan et al 5 have described a technique of endovascular stent grafting of subclavian artery aneurysm. In a literature review by Vierhout et al, 1 the authors noted a changing profile of diagnostic and therapeutic options for subclavian artery aneurysms, including increasing use of the endovascular approach to treat such aneurysms.…”

Endovascular repair of subclavian artery aneurysms: results from a single-center experience

“…8 The endovascular stent graft procedure is a viable option for SAAs in patients at prohibitive high risk for open surgical treatment and endovascular therapy is a treatment with a high success rate, low recurrences rate and few complications. 9 Computed tomographic angiography(CTA) was used to evaluate the actual size of the aneurismal sac because it is more precise than angiography when thrombosis exists. 10 In addition, CTA can also rule out TOS when 11 However, the patency result of endovascular treatment seems to have increased in recent studies and may further increase with the development of cover stents and post-procedural pharmacotherapy.…”

“…8 The endovascular stent graft procedure is a viable option for SAAs in patients at prohibitive high risk for open surgical treatment and endovascular therapy is a treatment with a high success rate, low recurrences rate and few complications. 9…”

Hybrid management of a ruptured right subclavian artery aneurysm dissection

“…4 , 5 Because of the difficult anatomy involved in aberrant subclavian aneurysms, endovascular techniques have emerged as a safe and reliable alternative. 6 , 7 TEVAR is used to exclude the aberrant subclavian artery from the aorta, and a posterior distal control is done as an open procedure (carotid-subclavian bypass with subclavian artery ligation proximally to the anastomosis).…”

“…Of these, only two referred to ruptured aneurysms, 8 , 9 and only one of these underwent repair. Twelve articles described hybrid or endovascular treatments for aberrant right subclavian artery aneurysms, 1 , 5 , 6 , 10 , 11 , 12 , 13 , 14 , 15 and the other 10 were unrelated to our topic. By exploring the bibliography of these papers, three others relevant to our research were found.…”