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1 Polish Journal of Surgery

1 2007

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Traumatic Injuries to Subclavian Arteries Treated with Stentgraft Implantation

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Juszkat R. , Stanišić M. , Dzieciuchowicz Ł. , Staniszewski R. , Pukacki F. , Oszkinis G. , Majewski W.

tom 79

nr 1

29-35

The aim of the study was to present the experience of our centre in endovascular treatment for subclavian artery injuries.Material and methods. In the years 2000-2005, seven patients (five men and two women, aged 28 to 69 years) with traumatic injuries to their subclavian arteries were treated in the Department of General and Vascular Surgery and Department of Radiology. Four patients were diagnosed with post-traumatic aneurysms including one iatrogenic aneurysm following fixation of a fractured clavicle; one patient experienced post-traumatic injury to subclavian artery; one with iatrogenic perforation of subclavian artery with bleeding into pleural cavity; and the last one with another iatrogenic injury resulting from attempts to place a central access line following surgical, restoration of patency within subclavian and axillary arteries. All patients underwent endovascular treatment with the use of self-expanding peripheral stentgrafts (Wallgraft, Boston Scientific, USA).Results. The procedure of stentgraft implantation was successfully performed in all seven patients. In the patient with iatrogenic injury to the subclavian artery, blood extravasation around the stent was observed the next day, which required the stent to be additionally expanded with a balloon catheter. No complications during or immediately after the procedure were detected in any patient. The patient with iatrogenic injury to the subclavian artery following clavicle fracture suffered from thrombosis within the brachial artery during the third week after the procedure.Conclusions. Endovascular treatment of subclavian artery injuries with the use of peripheral stentgrafts is an efficient method that is associated with low complication rates and should be the method of choice in the treatment of subclavian artery injuries.