Endovascular stented graft repair of a pseudoaneurysm of the subclavian artery caused by percutaneous internal jugular vein cannulation: case report

Abstract

In high-risk patients endovascular repair of a pseudoaneurysm with a stented graft is a safe and reasonable treatment option that can preclude significant morbidity and shorten hospital stay. We report a case of pseudoaneurysm of the subclavian artery after internal jugular vein cannulation that was treated successfully with an endovascularly inserted, stented graft. The case report highlights the importance of recognizing this unusual but serious complication of percutaneous internal jugular vein catheterization through careful clinical examination, prompt duplex scanning, and arteriography.

Brachial plexus palsy due to subclavian artery pseudo aneurysm from internal jugular cannulation

“…Treatment options for pseudoaneurysm are USG guided compression, percutaneous throbin injection, coil embolization, endovascular stents and open surgical repair. [8][9][10] USG guided compression which is frequently used for ablation of femoral pseudoaneurysm was not possible in our case because of depth of the artery and overlying bone. Percutaneous thrombin injection of pseudoaneurysm was not recommended because of potential for thrombin embolization into cerebral circulation.…”

Brachial plexus compression due to subclavian artery pseudoaneurysm from internal jugular vein catheterization

“…Treatment options for pseudoaneurysm are USG-guided compression, percutaneous thrombin injection, coil embolization, endovascular stents, and open surgical repair. [ 11 12 13 ] USG-guided compression which is frequently used for ablation of femoral pseudoaneurysm was not possible in our case because of depth of the artery and overlying bone. Cardiothoracic and vascular surgeon was consulted for endovascular stenting but was not feasible due to risk for cerebral embolization and stroke.…”

Endovascular repair of subclavian/axillary artery injury with a covered stent. A case report and review of literature

“…Exploration may be indicated in presence of infection or with tense hematoma especially in association with neurological dysfunction. Available evidence from the literature 7–14 has not shown any increased evidence of infection of stent grafts in this area, however we should be sensitive to any violation of the digestive tract, which may increase the chance of infection. In our opinion, antibiotics should be used preoperatively and for 5–7 days postoperatively in patients with traumatic disruption of subclavian-axillary vessels.…”

“…Early utilization of endovascular therapy for treating subclavian artery injuries has been reported since 1995, 11 where a covered stent was used to exclude a pseudoaneurysm. Sullivan et al 12 .…”