Subclavian Artery Aneurysms

Abstract

We report the management of 14 subclavian artery aneurysms (13 true, one false) occurring in seven male and seven female patients (average age, 48 years). The aetiology of the aneurysms included thoracic outlet syndrome in eight, atherosclerosis in five and infection in one patient. Twelve aneurysms were of extrathoracic location, while two aneurysms were intrathoracic. Symptoms related to subclavian artery aneurysms were present in 11 patients (compression in four, haemorrhage in one, and ischaemia in six patients), whereas three aneurysms were asymptomatic. All aneurysms were treated surgically. The supraclavicular approach was used in 11 cases, and the combined transsternal and supraclavicular approach was used in two cases. After aneurysm resection, the reconstruction was performed with end-to-end anastomosis in five cases and with saphenous vein or synthetic grafts in eight cases. One infected subclavian artery aneurysm was treated with carotid to axillary saphenous vein bypass after exclusion of the aneurysm. Five associated brachial embolectomies and one bypass from the axillary to the distal brachial artery were performed. In all thoracic outlet syndrome cases, decompression at the thoracic outlet was also performed. There was no operative mortality, and the early patency rate was 100%. The follow-up period was from 6 months to 10 years (mean, 3.92 years). During this period, one patient died of malignancy and one patient required reoperation due to aneurysmal degeneration of the saphenous vein graft. Surgical treatment is recommended for all patients with subclavian artery aneurysms to prevent potential complications.

An Atypical Cause of Shoulder Pain

“…These aneurysms are classified into two groups according to their etiologies, presentations, and therapeutic strategies: a) intrathoracic and b) extrathoracic. Those aneurysms that affect the intrathoracic portion of the subclavian artery develop mainly due to atherosclerosis, while those affecting the extrathoracic portion of the artery are usually due to trauma and thoracic outlet syndrome (5,7). In a very small portion of aneurysms, the etiologic factor can not be identified.…”

“…Malignant processes may give rise to shoulder pain due to infiltration of the lower truncus of the brachial plexus (4). In addition to these causative factors, aneurysms located in the upper mediastinum may lead to shoulder pain by means of pressure application on the lower truncus of the brachial plexus (5,6). Different and interesting cases of shoulder pain are being presented in this article.…”

Tratamento endovascular híbrido de aneurisma da artéria subclávia associado à síndrome de Marfan: relato de caso

“…In addition, genetic causes were identified, and there are three cases described in the literature. 9,10 The classical treatment consists of prosthetic graft interposition with terminoterminal anastomosis using a simple or combined transthoracic supraclavicular access. 11,12 Surgical treatment of subclavian artery aneurysms in patients with connective tissue disease may result in serious complications, such as artery deterioration, especially in those submitted to previous procedure.…”

“…16 Other authors described patency rates between 80 and 100%. 4,5,[9][10][11][12][13][15][16][17] Another application of the endovascular treatment documented in the literature was to exclude an iatrogenic pseudoaneurysm of the subclavian artery. 18,19 Schoder et al described a series of 12 patients submitted to endovascular treatment with implantation of a covered stent for aneurysmal disease and subclavian artery trauma.…”

INTERACTIVE CASE REPORT: Left Subclavian Artery Aneurysm after Gunshot Injury

“…En yaygın etiyolojik nedenler; ateroskleroz, enfeksiyonlar ve konjenital arteriyel anomaliler olarak bildirilirken, travmatik subklavian arter anevrizmaları çok nadir bildirilmiştir (1,2). On dört olguluk başka bir seride ise subklavian arter anevrizmalarında en sık etiyolojik nedenler olarak torasik outlet sendromu, ateroskleroz ve enfeksiyon bildirilmiştir (3). Subklavian arterin pseudoanevrizmaları da çok nadir görülür.…”