Endovascular Stent Graft Repair for True and Post-Traumatic False Aneurysms of the Subclavian Artery

Ann Vasc Surg. 2021 Aug:75:301-307. doi: 10.1016/j.avsg.2021.01.114. Epub 2021 Apr 3.

Abstract

Objective: Subclavian artery aneurysms (SAAs) are uncommon but life-threatening, and a standard treatment approach has yet to be established. The current study aimed to assess the safety and efficacy of endovascular treatment for SAAs.

Methods: The clinical data of 18 SAA patients who underwent endovascular repair at 3 hospitals from January 2009 to December 2019 were retrospectively collected and analyzed.

Results: Eighteen patients (12 men and 6 women) with a mean age of 61 years were included. Six patients (33.3%) had a history of hypertension, and 5 (27.8%) had a history of chest trauma. Five patients (27.8%) were asymptomatic. Thirteen (72.2%) SAAs were true aneurysms, and the others (27.8%) were posttraumatic false aneurysms. Endovascular stent graft repair was performed in all patients without conversion to open surgery. The immediate technique success rate was 94.4%, with no postoperative death and only one case (5.6%) of endoleak that was observed on intraoperative angiography and later resolved spontaneously. All patients survived over a median follow-up time of 57 months. Follow-up imaging showed that all stent grafts remained patent, with no endoleak.

Conclusions: Endovascular stent graft repair is feasible, safe, and effective for true and posttraumatic false SAAs and represents a promising treatment option for these SAAs.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Aneurysm / diagnostic imaging
  • Aneurysm / physiopathology
  • Aneurysm / surgery*
  • Aneurysm, False / diagnostic imaging
  • Aneurysm, False / physiopathology
  • Aneurysm, False / surgery*
  • Blood Vessel Prosthesis
  • Blood Vessel Prosthesis Implantation* / adverse effects
  • Blood Vessel Prosthesis Implantation* / instrumentation
  • Endoleak / etiology
  • Endovascular Procedures* / adverse effects
  • Endovascular Procedures* / instrumentation
  • Female
  • Humans
  • Male
  • Middle Aged
  • Retrospective Studies
  • Stents
  • Subclavian Artery / diagnostic imaging
  • Subclavian Artery / injuries
  • Subclavian Artery / physiopathology
  • Subclavian Artery / surgery*
  • Time Factors
  • Treatment Outcome
  • Vascular Patency
  • Vascular System Injuries / diagnostic imaging
  • Vascular System Injuries / physiopathology
  • Vascular System Injuries / surgery*