Urgent endovascular stent-graft placement for traumatic penetrating subclavian artery injuries

Associated Venous Injury Significantly Complicates Presentation, Management, and Outcomes of Axillosubclavian Arterial Trauma

“…10 Most other studies have smaller patient populations, but all advocated the effectiveness of endovascular treatment of ASVI. [11][12][13] Despite these single-center results, we found that endovascular treatment of ASVI only constituted 4.3% of the cohort. Although this low rate is subjected to multiple biases mentioned below, it most likely represents the true national trend as the NTDB encompasses a spectrum of hospital sizes as well as the endovascular expertise levels of different surgeons.…”

Traitement endovasculaire d’un faux anévrysme après lesion iatrogène de l’artère axillaire

“…Hilfiker et al 8 report five subclavian artery aneurysms and four subclavian artery fistulas treated with stent-grafts, reporting primary and secondary patencies of 89% and 100%, respectively, after a mean follow-up of 29 months. Patel et al 9 and Cohen et al 10 each report 6 cases of penetrating subclavian artery injury treated with stent-grafts, reporting 100% patency (mean follow-up 19 months) and 83% patency (mean follow-up 38 months), respectively.…”

Vascular Trauma: New Directions in Screening, Diagnosis and Management

“…Because of this alternatives to open surgical repair are very attractive, and there is growing experience with covered stents for treatment of subclavian artery injuries (Figure 8, 9a, 9b, 9c). Several case series have been reported revealing mortality of 0-33%, technical success rates ranging from 67-100%, primary patency rates of 83-100%, short term complications occurring in 0-22% of patients, and long term complications ranging from 0-32% (Carrick, et al, 2010;Castelli, et al, 2005;Cohen, et al, 2008;Danetz, et al, 2005;du Toit, et al, 2008;Hilfiker, et al, 2000). Short term complications most often include access site bleeding/hematoma, infection, pseudoaneurysm and fistula.…”

“…Despite this, some centers with significant endovascular experience and 24 hour a day on call interventional teams have utilized stent-grafts in unstable patients with some success (Cohen, et al, 2008). Other considerations/contra-indications for endovascular repair include vessel transection, and lack of a proximal vascular fixation site.…”