title: Elective and emergent endovascular treatment of subclavian artery aneurysms and injuries.
abstract: OBJECTIVE
  To demonstrate our short and long-term results after transbrachial treatment of subclavian artery aneurysms and injuries with stent-grafts in elective and emergency settings.
  
  
  METHODS
  Ten of 12 consecutive patients (6 men; mean age 63.8 years, range 38-80) were treated electively with commercially prepared endografts delivered via a transbrachial access to repair a subclavian artery aneurysm (n=3) or an injury from a misplaced central venous catheter (n=7). Two patients required emergency treatment for a ruptured atherosclerotic aneurysm in one and an unintentional arterial puncture during placement of a central venous access in the other. Stent-graft patency during follow-up was assessed by physical examination with comparison of brachial blood pressures in all patients; computed tomography angiography (CTA) was performed in available patients.
  
  
  RESULTS
  Successful deployment of stent-grafts with sealing of the lesion was achieved in all cases. There were 2 (17%) procedural complications. One patient developed an access-site hematoma that required surgical revision. The second patient, who had a right subclavian injury, suffered an embolic cerebral infarction. The primary stent-graft patency during follow-up (mean 11.6 months) was 100%. CTA examinations in 7 patients at a mean 18 months showed strut dislocation at the thoracic outlet without luminal narrowing in 1 patient. A 50% intraluminal narrowing due to compression between the clavicle and the first rib occurred in another patient. Six patients with a mean follow-up of 23 months (range 0.3-4.5 years) are still alive with patent stent-grafts.
  
  
  CONCLUSIONS
  Endovascular stent-graft treatment of subclavian artery aneurysms and injuries is a less invasive alternative to surgical repair. Long-term results must still be confirmed in further studies.
authors.affiliation: Department of Angiography and Interventional Radiology, University of Vienna, Austria. maria.schoder@univie.ac.at
authors.forename: Maria
authors.initials: M
authors.lastname: Schoder
authors.forename: Manfred
authors.initials: M
authors.lastname: Cejna
authors.forename: Thomas
authors.initials: T
authors.lastname: Hölzenbein
authors.forename: Georg
authors.initials: G
authors.lastname: Bischof
authors.forename: Fritz
authors.initials: F
authors.lastname: Lomoschitz
authors.forename: Martin
authors.initials: M
authors.lastname: Funovics
authors.forename: Iris
authors.initials: I
authors.lastname: Nöbauer-Huhmann
authors.forename: Irene
authors.initials: I
authors.lastname: Sulzbacher
authors.forename: Johannes
authors.initials: J
authors.lastname: Lammer
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000783:Aneurysm / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D000792:Angiography; D019917:Blood Vessel Prosthesis Implantation; D002405:Catheterization, Central Venous / Q000009:adverse effects; D017558:Elective Surgical Procedures; D004630:Emergencies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015607:Stents; D013348:Subclavian Artery / Q000000981:diagnostic imaging / Q000293:injuries / Q000601:surgery*; D016896:Treatment Outcome