Technique of endovascular repair of iatrogenic subclavian artery injury following subclavian vein catheterization
Abstract
The iatrogenic subclavian artery injury is a rare but potentially serious complication of subclavian vein cannulation.
The use of endovascular techniques is an alternative to surgical repair especially in patients with concomitant
diseases in whom immediate, potentially large surgery would be associated with a high risk of perioperative
complications. This article discusses technical aspects of endovascular repair of iatrogenic injury of subclavian
artery with implantation of covered stents based on two cases. Author’s experience and data from literature
suggests that endovascular management including covered stent implantation is safe and effective treatment
and should be considered as a method of choice especially among patients in poor general condition and/or
major comorbidities.
Keywords: subclavian arterycovered stentscentral cathetersiatrogenic injury
References
- Sznajder JI, Zveibil FR, Bitterman H, et al. Central vein catheterization. Failure and complication rates by three percutaneous approaches. Arch Intern Med. 1986; 146(2): 259–261.
- Rossi UG, Petrocelli F, Ferro C. Subclavian artery pseudoaneurysm complicating central venous catheterization: endovascular treatment with Amplatzer Vascular Plug 4 and covered stent. Catheter Cardiovasc Interv. 2013; 82(7): E906–E910.
- Wheeler SC, Zinn KM, Hughes TW. Endovascular covered stent repair of an iatrogenic subclavian artery-to-pulmonary artery fistula and pseudoaneurysm. J Vasc Interv Radiol. 2007; 18(6): 775–779.
- Stoica SC, Fleet M, Howd A. Subclavian artery injury following percutaneous insertion of dialysis catheter. Rev Med Chir Soc Med Nat Iasi. 1998; 102(3-4): 194–197.
- Cox CS, Allen GS, Fischer RP, et al. Blunt versus penetrating subclavian artery injury: presentation, injury pattern, and outcome. J Trauma. 1999; 46(3): 445–449.
- Waller CJ, Cogbill TH, Kallies KJ, et al. Contemporary management of subclavian and axillary artery injuries-A Western Trauma Association multicenter review. J Trauma Acute Care Surg. 2017; 83(6): 1023–1031.
- Tawfic QA, Bhakta P, Mohammed AK, et al. Subclavian vein injury and massive hemothorax requiring thoracotomy following insertion of tunneled dialysis catheter--a case report and review of literature. Middle East J Anaesthesiol. 2010; 20(6): 861–864.
- Maciejewski DR, Tekieli Ł, Machnik R, et al. Simultaneous vertebral and subclavian artery stenting. Postepy Kardiol Interwencyjnej. 2017; 13(2): 142–149.