Successful Treatment of Iatrogenic Subclavian Artery Pseudoaneurysm by Ultrasound-Guided Thrombin Injection

Yamashita, Yoshiyuki; Kimura, Satoshi; Kurisu, Kazuhiro; Ueno, Yasutaka

doi:10.3400/avd.cr.15-00091

Cited by 14 publications

(13 citation statements)

References 8 publications

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“…Positioning the needle tip away from the native artery or simultaneous use of a balloon across the neck of the pseudoaneurysm may prevent this. 4 In our patient, local thrombin injections would have resulted in a large thrombosed aneurysm, not relieving the mechanical burden. Full endovascular treatment was ruled out as an option because of the inevitability of covering adjacent vessels, risking a stroke or endoleak, and also because of the Marfan syndrome.…”

Section: Discussionmentioning

confidence: 66%

“…Conversely, important adjacent side branches may preclude endovascular repair by a covered stent or local thrombin injection. 2 , 3 , 4 We report a hybrid approach for treatment of a large pseudoaneurysm of the proximal right subclavian artery (RSA) caused by a puncture lesion during CVC placement for elective thoracic endovascular aortic repair. The patient consented to publication.…”

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confidence: 99%

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Hybrid repair of a large pseudoaneurysm of the proximal right subclavian artery in a Marfan patient

Weijde

Vos

Heijmen

2017

Journal of Vascular Surgery Cases, Innovations and Techniques

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A pseudoaneurysm of the proximal right subclavian artery is rare and most commonly caused by penetrating or blunt trauma. We report a case of a Marfan patient with a large iatrogenic pseudoaneurysm of the right subclavian artery, induced by a puncture lesion during central venous catheter placement for an elective endovascular thoracic aortic procedure. The patient was successfully treated with a hybrid approach, which consisted of endovascular coiling and balloon occlusion of the adjacent vessels, followed by open surgical exploration and uneventful closure of the puncture hole with the use of bovine pericardium-reinforced sutures.

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Section: Discussionmentioning

confidence: 66%

mentioning

confidence: 99%

Hybrid repair of a large pseudoaneurysm of the proximal right subclavian artery in a Marfan patient

Weijde

Vos

Heijmen

2017

Journal of Vascular Surgery Cases, Innovations and Techniques

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“…7 Pseudoaneurysm of the right subclavian artery usually occurs most commonly after major trauma or following iatrogenic trauma such those occurring during endovascular interventional procedures. 8,9 In this case, the patient presented about 3 weeks after his initial injury. The delayed presentation could be explained from the slow development of the pseudoaneurysm.…”

Section: Discussionmentioning

confidence: 96%

Delayed Endovascular Stenting of Right Subclavian Artery Pseudoaneurysm Caused by Gunshot Accident in a Syrian Refugee: A Case Report

Alawneh

Raffee

Hamouri

2017

Vasc Endovascular Surg

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Sharp penetrating injuries causing right subclavian artery pseudoaneurysm are considered rare. Surgical repair is reportedly associated with a high mortality rate and is considered technically challenging. In this case report, we report the successful endovascular repair of a delayed pseudoaneurysm of the right subclavian artery caused by a gunshot injury in a 22-year-old Syrian refugee that was associated with significant right brachial panplexopathy. The patient was successfully managed with angioplastic ballooning of the stenotic region of the artery and a covered self-expanding stent. The patient recovered uneventfully, and follow-up evaluation revealed significant improvement in neurological deficit.

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“…Both thrombin and cyanoacrylate glue (N-butyl-2cyanoacrylate) have been used successful as arterial embolic agent for endovascular treatment of pseudoaneurysms. 6,7 2. It can be easily diagnosed at bedside using ultrasonography, a color Doppler, and spectral Doppler examination.…”

Section: Discussionmentioning

confidence: 99%

A 54-Year-Old Man With Neck Swelling, Respiratory Distress, and Hoarseness

Dhungana

Bom

Niroula

et al. 2018

Chest

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A 54-year-old man, a known case of chronic kidney disease, presented to the ED with rapidly enlarging diffuse neck swelling on the right side (Fig 1A), respiratory distress, and hoarseness of the voice. On examination, there was a diffuse swelling on the right side of the neck and the trachea was pushed to the left. An inspiratory stridor was audible on auscultation. A week prior to presentation, he had undergone right internal jugular vein cannulation for a dialysis catheter placement. An ultrasonography examination of the neck was carried out in the ED which revealed an anechoic lesion measuring 40 Â 30 Â 20 mm with a 2-mm defect at the neck and a communication with right subclavian artery (Fig 1B). On color Doppler study, there was bidirectional blood flow in the lesion (Fig 1C). Spectral Doppler in the region of the defect showed biphasic reciprocating arterial waveforms (Fig 1D).

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Successful Treatment of Iatrogenic Subclavian Artery Pseudoaneurysm by Ultrasound-Guided Thrombin Injection

Cited by 14 publications

References 8 publications

Hybrid repair of a large pseudoaneurysm of the proximal right subclavian artery in a Marfan patient

Hybrid repair of a large pseudoaneurysm of the proximal right subclavian artery in a Marfan patient

Delayed Endovascular Stenting of Right Subclavian Artery Pseudoaneurysm Caused by Gunshot Accident in a Syrian Refugee: A Case Report

A 54-Year-Old Man With Neck Swelling, Respiratory Distress, and Hoarseness

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