Hybrid Repair of an Intrathoracic Bilobed Subclavian Artery Aneurysm

Gillen, Jenna; Tse, Lindsay; Berg, Arthur; Dardik, Herbert; Bernik, Thomas R.

doi:10.1016/j.avsg.2018.12.106

Cited by 6 publications

(3 citation statements)

References 5 publications

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“…Secondary complications, such as rupture, thrombosis, or embolization, are rare events. Aneurysms of other arteries were reported to be found in 33-47% of patients with an SAA at the time of diagnosis [41]. In comparison, in the present patient cohort, associated aneurysms of other arteries/aorta were found in 12.1% of patients with a mycotic SAA.…”

Section: Discussioncontrasting

confidence: 42%

Mycotic subclavian artery aneurysms: a scoping review

Yuan,

Yuan

2023

pwki

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Introduction: Mycotic subclavian artery aneurysms (SAAs) are a very rare disorder. Aim: To provide an overview of current knowledge on clinical features, management strategies and outcome evaluations of mycotic SAAs.Material and methods: The study materials were based on comprehensive literature retrieval of publications of mycotic SAAs published between 2000 and 2023.Results: 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.Conclusions: 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.

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Section: Discussioncontrasting

confidence: 42%

Mycotic subclavian artery aneurysms: a scoping review

Yuan,

Yuan

2023

pwki

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“…[15][16][17][18] Recently, hybrid management combining a covered stent and an extra-anatomical bypass has been reported to exclude intrathoracic right ISAAs, avoiding a mediastinal incision and presenting a favorable outcome. [19][20][21][22] Despite this, the invasion and postoperative complications are still non-negligible, especially for high-risk aged patients. Endovascular treatment has been reported to have a comparable overall mortality and complication rate with surgical repair.…”

Section: Discussionmentioning

confidence: 99%

Long-term outcomes of endovascular treatment of isolated subclavian artery aneurysms

Fang

et al. 2020

Vascular

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Objectives The aim of the present study was to review our institutional experience of endovascular treatment for isolated subclavian artery aneurysms and evaluate the long-term outcomes. Methods A retrospective review of all patients with isolated subclavian artery aneurysms who underwent endovascular treatment between March 2008 and March 2020 was performed. The demographics, aneurysmal characteristics, treatment strategies, and in-hospital and follow-up outcomes were recorded and then analyzed. Results From March 2008 to March 2020, 35 isolated subclavian artery aneurysms were endovascularly treated at our institution. Atherosclerosis was the most common cause of aneurysms in this series. Most aneurysms were intrathoracic (91.4%) and located at the right side (77.1%). There were 26 true aneurysms, seven pseudoaneurysms, and two ruptured isolated subclavian artery aneurysms. Five types of endovascular strategies were performed. Covered stent placement across the aneurysm was the most (54.3%) commonly used method. Technical success was achieved in all patients. The median postoperative in-hospital stay was 4.0 days (range, 1–15 days). One patient died after discharge but within 30 days of surgery due to myocardial infarction. The median follow-up time was 62.0 months (range, 3–132 months). No death, stroke, stent fractures, or severe upper limb ischemia developed during the follow-up period. The cumulative survival rate at five years was 97.1%. The overall complication rate was 25.7% and one-third of complications (8.6%) required reinterventions. Conclusions Endovascular treatment for isolated subclavian artery aneurysms is safe, effective and technically achievable in most patients. Short- and long-term outcomes are promising. Reasonable and flexible use of covered stents can also get satisfactory outcomes in some complicated lesions such as isolated subclavian artery aneurysms located at the origin of the right subclavian artery, avoiding the huge surgical trauma caused by conventional open repair.

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“…[2][3][4] Reports on subclavian artery aneurysms after 2018 are shown in Table 1. 3,[13][14][15][16][17][18][19][20][21][22] Treatment methods consisted of open surgery in 25 patients, endovascular treatment in 13, and their combination in 3. Endovascular treatment procedures consisted of stent grafting in 12 patients, stenting in 2, stent-assisted coil embolization in 1, and coil embolization in 1.…”

Section: Discussionmentioning

confidence: 99%

Successful Balloon-assisted Coil Embolization of Right Subclavian Artery Aneurysm: A Case Report

Nampei

Shiba

Sakaida

et al. 2020

JNET

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Objective: Subclavian artery aneurysms are relatively rare, and have been treated by open surgery and/or endovascular treatment using a stent graft. In this article, we report a case of unruptured right subclavian artery aneurysm successfully treated using balloon-assisted coil embolization. Case Presentation:A 77-year-old man was diagnosed with an asymptomatic unruptured right subclavian artery aneurysm of 8 mm in diameter by follow-up CTA after surgery for thoracoabdominal aortic aneurysms. He also had a history of cerebral infarction and clipping of an unruptured cerebral aneurysm. The subclavian artery aneurysm was treated by balloon-assisted coil embolization because its diameter increased to 17.6 mm in 2 years. Balloon assistance was mainly used to prevent protrusion of the framing coil into the parent artery, and satisfactory framing was achieved.Subsequently, the aneurysm was obliterated using filling and finishing coils. The postoperative course was uneventful, and the follow-up MRI at 18 months after treatment revealed no recanalization of the aneurysm. Conclusion:Balloon-assisted coil embolization may be an effective treatment for subclavian artery aneurysms, but further long-term follow-up and case accumulation are needed.Keywords▶ subclavian artery aneurysm, balloon-assisted coil embolization, endovascular, total arch replacement This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives International License.

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Hybrid Repair of an Intrathoracic Bilobed Subclavian Artery Aneurysm

Cited by 6 publications

References 5 publications

Mycotic subclavian artery aneurysms: a scoping review

Mycotic subclavian artery aneurysms: a scoping review

Long-term outcomes of endovascular treatment of isolated subclavian artery aneurysms

Successful Balloon-assisted Coil Embolization of Right Subclavian Artery Aneurysm: A Case Report

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