Issue: Vojnosanit Pregl 2016; Vol. 73 (No. 10):
Endovascular treatment of the subclavian artery aneurysm in high-risk patients – A single-center experience
Authors:
Ivan Marjanović, Aleksandar Tomić, Nebojša Marić, Danijela Pecarski, Momir Šarac, Dragana Paunović, Siniša Rusović
Background/Aim. Subclavian artery aneurysm (SAA) is a rare disease, but with serious complications. Recently, besides open surgical procedure, appearance of the stent-grafts enables endovascular reconstruction. We presented our first experience with endovascular treatment of 6 SAA occurring in five male and one female patient. Methods. All the patients, in our studies, according to ASA classification were at high risk of open repair of SAA. The etiology of all aneurysms was atherosclerotic degeneration of the artery. Two aneurysms were at intrathoracic location, and the other ones were extrathoracic. Symptoms related to SAA were present in two of the patients, compression and chest pain in one, and hemorrhage shock in another one. Other patients were asymptomatic. We preferred the Viabhan endoprosthesis for endovascular repair in 5 cases. In one patient with rupture of SAA, who was at high risk of open repair we performed a combined endovascular procedure. First of all, we covered the origin of the left subclavian artery with thoracic stent graft and after that put two coils in a proximal part of the subclavian artery. Results. There was no operative mortality, and the early patency rate was 100%. The follow-up period was from 3 months to 3 years. During this period, one patient died of heart failure and another one required endovascular reoperation due to endoleak type I. Conclusion. Endovascular treatment is recommended for all patients with SAA whenever it is possible due to anatomical reasons especially in high-risk patients with intrathoracic localization of aneurysm, to prevent potential complications.