A 44-year-old man who had sustained injuries to the chest and left upper extremity was admitted to our hospital. The radial pulse was not palpated at the left wrist. Angiography showed occlusion of the left subclavian artery with mediastinal hematoma. The left vertebral artery filled in a retrograde direction and the distal left subclavian artery could be visualized by filling from the left vertebral artery. He had no ischemic neurological symptom but was immediately operated on to prevent hemorrhage. Through a median sternotomy the injured portion of the left subclavian artery was removed and replaced by a dacron prosthesis. The specimen represented that the artery was completely divided and occluded with thrombus. Recovery was uneventful. This was the seventh case of traumatic subclavian steal syndrome. Vascular repair should be made soon in traumatic subclavian steal syndrome because collateral circulation is poor compared with that in arteriosclerotic obstruction.
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Biomedicines
January 2025
Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, MI 48109, USA.
Subclavian artery pseudoaneurysms are rare but potentially life-threatening vascular injuries frequently associated with trauma such as clavicle fractures. In this paper we describe the case of a 49-year-old male who developed a post-traumatic pseudoaneurysm of the subclavian artery after a bicycle accident. The diagnosis was delayed due to non-specific symptoms and an initially missed aneurysm on computed tomography imaging.
View Article and Find Full Text PDFRadiol Case Rep
March 2025
Department of Diagnostic and Interventional Radiology, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki, Kanagawa 216-8511, Japan.
With advancements in medical devices and imaging techniques, endovascular treatment using stent grafts has emerged as a viable and aggressive therapeutic option for traumatic subclavian artery injuries, including iatrogenic cases. Existing literature suggests that endovascular treatment is less invasive and offers hemostatic success rates comparable to traditional surgical methods. However, there is a paucity of case reports, necessitating further investigation into treatment indications and procedural challenges.
View Article and Find Full Text PDFCureus
December 2024
Vascular Surgery, Unidade Local de Saúde São José, Lisbon, PRT.
Subclavian artery pseudoaneurysms (SAPs) are rare and most often secondary to trauma. On the contrary, a mycotic origin is exceedingly rare, and defining this etiology can become challenging. We present a rare case of a tuberculous SAP in a young patient.
View Article and Find Full Text PDFJ Surg Case Rep
December 2024
Department of Surgery, Hackensack Meridian Health Jersey Shore University Medical Center, 1945 Route 33, Neptune, NJ 07756, United States.
Subclavian arteriovenous fistulas (AVFs) are rare entities, mostly reported as a result of traumatic and iatrogenic injuries. In the literature, congenital subclavian AVFs are also presented. Diagnosis of traumatic AVF may present challenges given the variable clinical presentation, varying location, and difficulty to locate on imaging.
View Article and Find Full Text PDFNeurocrit Care
November 2024
Division of Neurocritical Care, Department of Neurology and Neurosurgery, Emory University School of Medicine, 1364 Clifton Rd NE, Atlanta, GA, 30322, USA.
Background: Classic teaching in neurocritical care is to avoid jugular access for central venous catheterization (CVC) because of a presumed risk of increasing intracranial pressure (ICP). Limited data exist to test this hypothesis. Aneurysmal subarachnoid hemorrhage (aSAH) leads to diffuse cerebral edema and often requires external ventricular drains (EVDs), which provide direct ICP measurements.
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