Urgent endovascular stent-graft placement for traumatic penetrating subclavian artery injuries

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• 作者：José ; E. Cohen ; Gustavo Rajz ; John M. Gomori ; Anthony Verst ; ig ; Yacov Berlatzky ; Haim Anner ; Savvas Grigoriadis ; Pedro Lylyk ; Rosana Ceratto ; Alex Klimov
• 关键词：Penetrating injury ; Subclavian artery ; Pseudoaneurysms ; Arteriovenous fistula ; Stent-graft
• 刊名：Journal of the Neurological Sciences
• 出版年：2008
• 出版时间：15 September 2008
• 年：2008
• 卷：272
• 期：1-2
• 页码：151-157
• 全文大小：757 K

文摘

Penetrating injuries may infrequently cause pseudoaneurysms, lacerations and arteriovenous fistulas involving the subclavian artery. These injuries present with life-threatening bleedings, associated regional injuries and critical limb ischemia and although surgery has been considered the treatment of choice, subclavian injuries pose a real surgical challenge. We prospectively examined data of six patients presenting with penetrating subclavian artery injuries that were treated by urgent endovascular stent-graft placements. All stent-grafts were deployed successfully achieving complete exclusion of the pseudoaneurysm, control of bleeding and reconstruction of the injured artery. No procedural complications, stent thrombosis or stent infections occurred during hospitalization. One patient developed stenosis at 7 months, which required angioplasty. The series mean clinical and ultrasound-CTA follow-up is 38 +/− 19.7 months (range 11–60 months) and 28 +/− 19.1 months (range 6–58 months), respectively. This series shows the feasibility of endovascular repair by means of stent-grafts for selected patients with acute penetrating injuries of the subclavian arteries. This approach proved to be safe and effective in restoring the arterial lumen and patency, excluding the pseudoaneurysms and controlling the bleeding caused by subclavian lacerations. Mid-term follow-up on stent-graft patency rates are encouraging.