Successful Treatment of a Ruptured Subclavian Artery Aneurysm Presenting as Hemoptysis with a Covered Stent

다국어 초록 (Multilingual Abstract)

An aneurysm of the subclavian artery is rare. Recently, we experienced a case of a rupturedsubclavian artery aneurysm presenting as hemoptysis. The patient had experiencedatypical chest discomfort, and computed tomography (CT) revealed a smallaneurysm of the left subclavian artery (SCA). Hemoptysis occurred 2 weeks later. Follow-up CT showed a ruptured aneurysm at the proximal left SCA. Endovasculartreatment with a graft stent was performed by bilateral arterial access with a 12-Frintroducer sheath placed via cutdown of the left axillary artery and an 8-Fr sheath inthe right femoral artery. A self-expandable Viabahn covered stent measuring 13×5 mmwas introduced retrogradely via the left axillary sheath and was positioned under contrastguidance with an 8-Fr JR4 guide through the femoral sheath. After the procedure,hemoptysis was not found, and the 3-month follow-up CT showed luminal patency ofthe left proximal SCA and considerable reduction of the hematoma.

참고문헌 (Reference)

1 Phipp LH, "Subclavian stents and stent-grafts: cause for concern?" 6 : 223-226, 1999

2 Mohan IV, "Peripheral arterial aneurysms: open or endovascular surgery?" 56 : 36-56, 2013

3 Dent TL, "Multiple arteriosclerotic arterial aneurysms" 105 : 338-344, 1972

4 du Toit DF, "Long-term results of stent graft treatment of subclavian artery injuries: management of choice for stable patients?" 47 : 739-743, 2008

5 Halsted WS, "Ligation of the first portion of the left subclavian artery and excision of a subclavian axillary aneurysm" 24 : 93-, 1892

6 Andersen ND, "Intrathoracic subclavian artery aneurysm repair in the thoracic endovascular aortic repair era" 57 : 915-925, 2013

7 Chen YF, "Endovascular treatment of a nontraumatic left subclavian artery pseudoaneurysm" 75 : 474-478, 2012

8 Sitsen ME, "Deformation of self-expanding stent-grafts complicating endovascular peripheral aneurysm repair" 6 : 288-292, 1999

9 Kasirajan K, "Covered stents for true subclavian aneurysms in patients with degenerative connective tissue disorders" 10 : 647-652, 2003

10 Vierhout BP, "Changing profiles of diagnostic and treatment options in subclavian artery aneurysms" 40 : 27-34, 2010