Τίτλος:
Management of iatrogenic subclavian artery pseudoaneurysms
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Background To report our experience in the management of iatrogenic subclavian artery pseudoaneurysms (SAPs). Methods During a 6-year period, 5 patients were treated urgently for SAP. Results Two patients presented with rupture, 2 with dyspnea, whereas 1 had unremitting severe pain. Three patients underwent preoperative computed tomography angiography and 2 digital subtraction angiography. Three patients were treated with an open surgical procedure, whereas 2 were managed by endovascular means. A combined supraclavicular and/or infraclavicular approach was used in 2 patients, whereas a midsternotomy was mandatory to achieve proximal control in one. A combined transfemoral and/or brachial approach was used in both patients treated endovascular. No perioperative deaths or procedure-related complications occurred. All symptoms were relieved, whereas the median hospital stay was 8 days. During a mean follow-up period of 20.4 ± 10 months, none of the patients needed any reintervention. Conclusions Iatrogenic SAPs constitute a clinical entity that may need surgical treatment, especially in the presence of symptoms. In relatively stable patients with no major compression issues, stenting could be considered as an adequate therapy for these situations. Open surgical repair should be considered when there is significant compression of adjacent structures or failure of the endovascular approach. © 2015 Elsevier Inc. All rights reserved.
Συγγραφείς:
Klonaris, C.
Kouvelos, G.
Doulaptsis, M.
Katsargyris, A.
Chatziioannou, A.
Περιοδικό:
Annals of Vascular Surgery
Εκδότης:
HANLEY & BELFUS-ELSEVIER INC
Λέξεις-κλειδιά:
aged; aneurysm rupture; angiography; Article; chronic kidney disease; clinical article; clinical examination; computer assisted tomography; digital subtraction angiography; dysphagia; dyspnea; false aneurysm; female; hoarseness; hospitalization; human; male; pain severity; preoperative period; priority journal; sternotomy; subclavian artery; surgical approach; surgical technique; Aneurysm, False; Aneurysm, Ruptured; blood vessel prosthesis; blood vessel transplantation; case report; devices; endovascular surgery; iatrogenic disease; injuries; length of stay; magnetic resonance angiography; middle aged; radiography; stent; subclavian artery; time factor; treatment outcome; Vascular System Injuries, Aged; Aneurysm, False; Aneurysm, Ruptured; Angiography, Digital Subtraction; Blood Vessel Prosthesis; Blood Vessel Prosthesis Implantation; Endovascular Procedures; Female; Humans; Iatrogenic Disease; Length of Stay; Magnetic Resonance Angiography; Male; Middle Aged; Stents; Subclavian Artery; Time Factors; Tomography, X-Ray Computed; Treatment Outcome; Vascular System Injuries
DOI:
10.1016/j.avsg.2015.03.047
