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International Society For Minimally Invasive Cardiothoracic Surgery

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Endovascular Closure Of Right Subclavian Artery Aneurysm
Rafael Garcia-Borbolla Fernández, Bella Ramirez González, Enrique Perez Duarte, Mariano Garcia-Borbolla Balboa, Mariano Garcia-Borbolla Fernández.
Hospital Infanta Luisa, Sevilla, Spain.

Background: True aneurysms of the brachial and axillary artery are encountered rarely. Are mostly originate from trauma, mycotic lesions, thoracic outlet syndrome, previous arteriovenous fistulae and atherosclerosis. They can be diagnosed by simple physical examination as a pulsatile mass. Methods: An 47 year-old woman admitted after study for casual pulsatile mass in the neck. Her personal history showed a cutaneous angioma in right supraclavicular region that was operated in the childhood with cauterization above. Computed tomography angiography of the whole aorta revealed a right subclavian artery aneurysm with calcification originating from the proximal right subclavian artery, approximately 62.5 × 30.3 mm in size. Considering the large trauma and high risk of surgery, we attempted to perform a transcatheter closure of this giant artery aneurysm. Results: Selective angiography via right radial artery as performed showing the great aneurysm distal to the origin of right mamarian artery. Subsequently, we decide to approach the case with the implantation of self-expanding endoluminal endoprosthesis with ePTFE and nitinol. The procedure was performed by femoral approach (8F). Postprocedure angio revealed optimal device positioning, complete exclusion of the aneurysm and no obstruction of the right common carotid artery. CT scan in the follow up showed a complete resolution of the aneurysm. After 18 months of follow up no further complications were related. Conclusions: Although this is a challenge of interventional techniques, we succesfully treated a rare type of subclavian aneurysms by the use of endovascular prothesis, suggesting that the transcatheter. LEGEND: Left Angiography pre and post procedure. Right: CT scan pre and post.


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