Technique of endovascular repair of iatrogenic subclavian artery injury following subclavian vein catheterization

Abstract

The iatrogenic subclavian artery injury is a rare but potentially serious complication of subclavian vein cannulation. The use of endovascular techniques is an alternative to surgical repair especially in patients with concomitant diseases in whom immediate, potentially large surgery would be associated with a high risk of perioperative complications. This article discusses technical aspects of endovascular repair of iatrogenic injury of subclavian artery with implantation of covered stents based on two cases. Author's experience and data from literature suggests that endovascular management including covered stent implantation is safe and effective treatment and should be considered as a method of choice especially among patients in poor general condition and/or major comorbidities.

Iatrogenic subclavian artery rupture: A unique case report on balloon occlusion

“…Numerous authors advocate that expanded balloon diameters must equal or exceed arterial lumen diameters for balloon occlusion and for stent grafts [ 2 , 3 , 6 , 8 ]. We present a balloon occlusion case in which expanded balloon diameter was purposefully smaller than arterial diameter, and in which no additional interventions were necessary.…”

“…Most frequent approaches are via femoral, internal jugular, and subclavian veins [ 1 ]. 30 % of nonimage guided and 18 % of image guided central lines result in failures and/or complications [ 2 ]. Arterial injury is reported in 3.7–8 % of cases [ 3 ].…”

“…Choosing balloon diameter equal to or exceeding arterial diameter is virtually universally advised in order to effect cessation of extravasation [ 2 , 3 , 6 ]. We report a case in which the balloon was smaller than the injured subclavian artery lumen.…”