Hemoptysis caused by a left subclavian pseudoaneurysm: endovascular solution for a challenging case

Vascular ◽  
2013 ◽  
Vol 21 (3) ◽  
pp. 159-162 ◽  
Author(s):  
Lucas Ribé Bernal ◽  
Juan Luis Portero ◽  
María Vila ◽  
Diego Fernando Ruiz ◽  
Luis Manuel Reparaz
Keyword(s):  
Stent Graft ◽  
Subclavian Artery ◽  
Left Subclavian Artery ◽  
Massive Hemoptysis ◽  
Artery Pseudoaneurysm ◽  
Parenchymal Lesion ◽  
Lesion Treatment ◽  
Thoracic Stent Graft

This is one of the first reports of a left subclavian pseudoaneurysm in a patient presenting with massive hemoptysis. We present a challenging case of a patient who consulted for hemoptysis. Imaging revealed a left subclavian artery pseudoaneurysm that caused a pulmonary parenchymal lesion. Treatment with a self-expanding thoracic stent-graft and a subclavian occluder was successful.

Stent-Graft Repair of a Mycotic Left Subclavian Artery Pseudoaneurysm

2003 ◽  
Vol 10 (1) ◽  
pp. 66-70 ◽  
Author(s):  
Junichiro Sanada ◽  
Osamu Matsui ◽  
Noboru Terayama ◽  
Satoshi Kobayashi ◽  
Tetsuya Minami ◽  
...  
Keyword(s):  
Stent Graft ◽  
Subclavian Artery ◽  
Left Subclavian Artery ◽  
Artery Pseudoaneurysm ◽  
Stent Graft Repair

Anatomical repair for Kommerell diverticulum with deep site in-situ fenestration

2018 ◽  
Vol 26 (6) ◽  
pp. 467-469
Author(s):  
Masami Shingaki ◽  
Yoshihiko Kurimoto ◽  
Kiyofumi Morishita ◽  
Toshio Baba ◽  
Tsuyoshi Shibata ◽  
...  
Keyword(s):  
Stent Graft ◽  
Subclavian Artery ◽  
Endovascular Repair ◽  
Left Subclavian Artery ◽  
The Third ◽  
Deep Site ◽  
Main Component ◽  
Thoracic Stent Graft ◽  
Kommerell Diverticulum

An 83-year-old woman with a Kommerell diverticulum was treated by anatomical endovascular repair with a deep site in-situ fenestration instead of complex debranching techniques. The main component of the thoracic stent-graft was deployed just distal to the third cervical branch to completely exclude the Kommerell diverticulum. A deep site in-situ fenestration was made on the main component using a radiofrequency needle through the left subclavian artery, and a stent-graft was deployed to bridge the main component to the left subclavian artery. Six months postoperatively, the Kommerell diverticulum was completely excluded with excellent left subclavian artery patency.

Stent-Graft Repair of a Mycotic Left Subclavian Artery Pseudoaneurysm

2003 ◽  
Vol 10 (1) ◽  
pp. 66-70 ◽  
Author(s):  
Junichiro Sanada ◽  
Osamu Matsui ◽  
Noboru Terayama ◽  
Satoshi Kobayashi ◽  
Tetsuya Minami ◽  
...  
Keyword(s):  
Ct Scan ◽  
Stent Graft ◽  
Subclavian Artery ◽  
Left Subclavian Artery ◽  
Polyester Fabric ◽  
Marrow Transplant ◽  
Immunosuppressed Patient ◽  
Artery Pseudoaneurysm ◽  
Computed Tomographic ◽  
Mycotic Aneurysms

Purpose: To report successful stent-graft treatment of a mycotic pseudoaneurysm of the left subclavian artery in an immunosuppressed patient. Case Report: A 17-year-old immunosuppressed woman undergoing treatment for recurrent leukemia developed persistent fever and 2 episodes of hemoptysis. A contrast-enhanced computed tomographic (CT) scan demonstrated a saccular aneurysm of the left subclavian artery, which was considered to be a mycotic aneurysm caused by erosive fungal infection from the lung. The pseudoaneurysm was treated with a homemade stent-graft consisting of a nitinol stent and a polyester fabric. A type II endoleak present at the end of the procedure appeared to have sealed spontaneously on the CT scan at 3 days. No neurological deficit or ischemic symptoms of the left arm were noted during the follow-up, which lasted until the patient died 11 months later after rejecting a second bone marrow transplant. Conclusions: Endovascular repair may be an alternative to open surgery for the management of mycotic aneurysms of the subclavian artery.

Complications after Endovascular Repair of Type B Aortic Dissection

2002 ◽  
Vol 9 (6) ◽  
pp. 822-828 ◽  
Author(s):  
Reinhard S. Pamler ◽  
Thomas Kotsis ◽  
Johannes Görich ◽  
Xaver Kapfer ◽  
Karl-Heinz Orend ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Stent Graft ◽  
Subclavian Artery ◽  
Left Subclavian Artery ◽  
Type B ◽  
Type B Aortic Dissection ◽  
Stent Grafting ◽  
Stent Graft Implantation ◽  
Graft Implantation

Purpose: To outline the complications encountered after endoluminal treatment in patients with type B aortic dissection. Methods: Between 1999 and 2001, 14 patients (12 men; mean age 60.3 years, range 39–79) with isolated type B aortic dissection (13 chronic, 1 acute) underwent aortic stent-grafting. Three patients with chronic dissection presented an acute clinical picture and were managed emergently. The left subclavian artery was intentionally covered by the prosthesis in 9 patients. Follow-up studies were performed at 6-month intervals. Results: Stent-graft implantation was technically successful in all patients, but incomplete sealing (endoleak) of the entry site required additional proximal stent-graft implantation in 4. The left subclavian artery remained patent in 5 patients. Secondary conversion was required in 3 patients: 2 for acute type A dissection resulting from injury to the aortic arch by Talent endografts and a sustained hemorrhage (left hemothorax). In another patient, a secondary intramural hematoma subsided spontaneously. Anterior spinal artery syndrome in 1 patient persisted at 1 month. No bypass was necessary for the 9 patients with the covered left subclavian arteries. Mean follow-up was 14 months (range 1–23). Conclusions: Stent-grafting is feasible in patients with type B aortic dissection, although it is associated with a considerable rate of complications. Frank reporting of these sequelae for a variety of stent-grafts is of paramount importance to clarifying the limitations of the method.

scholarly journals Handmade stent graft fenestration to preserve left subclavian artery in thoracic endovascular aortic repair†

2019 ◽  
Vol 56 (3) ◽  
pp. 587-594 ◽  
Author(s):  
Huey-Shiuan Kuo ◽  
Jih-Hsin Huang ◽  
Jer-Shen Chen
Keyword(s):  
Carotid Artery ◽  
Stent Graft ◽  
Subclavian Artery ◽  
Common Carotid Artery ◽  
Left Subclavian Artery ◽  
Thoracic Endovascular Aortic Repair ◽  
Endovascular Aortic Repair ◽  
Technical Success ◽  
Aortic Stent Graft ◽  
Aortic Pathologies

Abstract OBJECTIVES This study aimed to evaluate the efficacy and safety of a handmade fenestrated stent graft over an aortic stent graft for preserving the left subclavian artery (LSA) in thoracic endovascular aortic repair (TEVAR). METHODS From July 2015 to October 2018, a total of 32 consecutive patients with various thoracic aortic pathologies who underwent TEVAR in which handmade fenestration over a thoracic aortic stent graft was used for LSA were included. Outcomes including technical success, procedure-related complications, perioperative mortality and morbidity and graft patency were analysed. RESULTS Twenty-four patients (75.00%) presented with aortic dissection, 5 patients (15.63%) with thoracic aortic aneurysm and 2 patients (6.25%) with penetrating aortic ulcer; 1 patient (3.13%) required re-TEVAR due to endoleak and sac expansion from previous TEVAR for thoraco-abdominal aneurysm. TEVAR was performed in a zone 2 landing with single fenestration for LSA (26 patients, 81.25%), zone 1 landing with double fenestration for both LSA and left common carotid artery (5 patients, 15.63%) or zone 1 landing with single fenestration for LSA and a chimney graft for left common carotid artery (1 patient, 3.13%). The technical success rate, defined as the successful alignment of fenestration to LSA, was 93.75%. At a mean follow-up of 17.3 months, 4 cases of endoleak and 2 cases of stent graft-induced new entry were noted, 3 of which were treated endovascularly. CONCLUSIONS Our preliminary results demonstrate the viability of preserving LSA blood flow in TEVAR using a handmade stent graft fenestration to treat various aortic pathologies in various clinical situations and the technical feasibility and short-term results that may justify the use of this method in emergency cases.

Management strategies for thoracic stent-graft repair of distal aortic arch lesions: is intentional subclavian artery occlusion a safe procedure?

2009 ◽  
Vol 19 (10) ◽  
pp. 2407-2415 ◽  
Author(s):  
Fabrizio Fanelli ◽  
Michael D. Dake ◽  
Filippo Maria Salvatori ◽  
Armando Pucci ◽  
Giuseppe Mazzesi ◽  
...  
Keyword(s):  
Aortic Arch ◽  
Stent Graft ◽  
Subclavian Artery ◽  
Management Strategies ◽  
Artery Occlusion ◽  
Safe Procedure ◽  
Subclavian Artery Occlusion ◽  
Stent Graft Repair ◽  
Thoracic Stent Graft

scholarly journals Endovascular Management of Right Subclavian Artery Pseudoaneurysm due to War Injury in Adolescent Patient

2017 ◽  
Vol 2017 ◽  
pp. 1-4 ◽  
Author(s):  
Onur Saydam ◽  
Deniz Şerefli ◽  
Mehmet Atay ◽  
Cengiz Sert
Keyword(s):  
Stent Graft ◽  
Subclavian Artery ◽  
Dual Antiplatelet Therapy ◽  
Vascular Injuries ◽  
Endovascular Management ◽  
Artery Pseudoaneurysm ◽  
Nitinol Stent ◽  
First Case ◽  
Alternative Approach ◽  
Residual Lesions

Today there is a widespread use of endovascular treatment (EVT) for traumatic vascular injuries in adults, but there is lack of evidence of its use in adolescent patients with vascular injuries. With this case, we present successful EVT of 14-year-old adolescent with a right subclavian artery pseudoaneurysm (SAP) due to war injury. SAP was successfully excluded with deployment of 6×50 mm flexible, self-expanding covered nitinol stent graft (The GORE® VIABAHN® Endoprosthesis (W.L. Gore & Associates, Flagstaff, AZ)). Patient was discharged from hospital 2 days after the procedure with dual antiplatelet therapy (clopidogrel and aspirin). 3 months after discharge control DUS showed patent stent graft without any residual lesions. As a result, EVT is an alternative approach to treatment of SAP. It is safe, effective, and less invasive therapy for SAP in adults as well as in adolescents. We aim to contribute to the literature with this first case report.

Suturing Fenestration of the Left Subclavian Artery Orifice in Frozen Elephant Trunk Procedure

2020 ◽  
Author(s):  
Mitsumasa Hata ◽  
Shinji Wakui ◽  
Yusuke Ishii ◽  
Rei Hinoura ◽  
Susumu Isaka ◽  
...  
Keyword(s):  
Aortic Arch ◽  
Stent Graft ◽  
Subclavian Artery ◽  
Distal Part ◽  
Left Subclavian Artery ◽  
Frozen Elephant Trunk ◽  
Bleeding Events ◽  
Elephant Trunk ◽  
Novel Technique ◽  
Elephant Trunk Procedure

AbstractThe frozen elephant trunk (FET) procedure enables easier replacement of the entire aortic arch because it does not require reaching the distal part of the left subclavian artery (LSCA). However, it requires additional management for reconstruction of the LSCA, which is associated with bleeding events. However, the fenestrated FET technique confers a risk of endoleakage from the fenestration site. We report our unique novel technique in which the proximal side of the hybrid stent graft is cut into V-shape around the subclavian artery and sutured continuously around the orifice of the subclavian artery during aortic stump fixation.

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