[Percutaneous angioplasty (PTA) in the treatment of non-penetrating injuries to the subclavian artery. A clinical case].
Non penetrating injuries to the subclavian vessels are uncommon. We present a case of a young patient with an isolated blunt trauma of the right subclavian artery. The patient, a 25 year-old woman, was admitted to our Institute after a motor-vehicle accident, with a physical findings of absent peripheral pulses and right clavicular fracture, confirmed by non-invasive vascular evaluation and X-ray of the chest. Diagnosis was established by an urgent selective angiography that showed a subintimal hematoma with occlusion of the vessel and peripheral ischemia of the arm. The patient clinical status (hemodynamically stable) permitted a conservative management and a transluminal percutaneous angioplasty (PTA) with a trans-femoral catheter balloon. After radiologic treatment, the patient showed good palpable peripheral pulses. Clavicular fracture was treated by esternal stabilization. We believe that in selected patients, without other serious life-threatening injures, the intimal artery injury can be treated by a conservative and now also radiologic Therapy; PTA treatment avoids morbidity and mortality associated with surgical intervention.
Giordanengo
F
F
Istituto di Chirurgia Generale e Cardiovascolare, Università degli Studi, Milano.
Boneschi
M
M
Giorgetti
P L
PL
Lovaria
A
A
D000063:Accidents, Traffic; D000328:Adult; D017222:Angioplasty, Balloon, Laser-Assisted; D002533:Cerebral Angiography; D005260:Female; D006801:Humans; D013348:Subclavian Artery / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D014949:Wounds, Nonpenetrating / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery