Iatrogenic subtotal stenosis of the right subclavian artery treated with percutaneous transluminal angioplasty.
This report describes a rare vascular complication of surgical placement of a marking clip and a possible approach to problem solving. A 55-year-old patient presented with loss of sensation in the fingers and loss of peripheral pulsations in the right arm 4 days after right upper lobectomy for a pT2N1 moderately differentiated adenocarcinoma of the lung. Duplex examination and computed tomography were performed the same day and showed a subtotal stenosis of the right subclavian artery, which was caused by the surgical placement of a metal clip to mark the surgical boundary. Selective angiography was subsequently performed. Percutaneous transluminal angioplasty (PTA) successfully dilated the stenosis and pushed the clip off. Flow in the right subclavian artery (RSA) was completely restored as were neurology and peripheral pulses. In conclusion, arterial stenosis by a surgical (marking) clip may be feasibly treated with PTA.
Smeenk
Robert M
RM
Department of Surgery, Albert Schweitzer Hospital, Albert Schweizterplaats 25, 3318 AT Dordrecht, The Netherlands. r.m.smeenk@asz.nl
Kock
Mark C J M
MC
Elgersma
Otto E H
OE
Schnater
Marco J
MJ
D000230:Adenocarcinoma / Q000473:pathology / Q000601:surgery*; D000792:Angiography; D020099:Coated Materials, Biocompatible; D003251:Constriction, Pathologic / Q000175:diagnosis / Q000628:therapy; D005385:Fingers / Q000098:blood supply; D005471:Fluoroscopy; D006801:Humans; D007049:Iatrogenic Disease; D007091:Image Processing, Computer-Assisted; D021621:Imaging, Three-Dimensional; D007511:Ischemia / Q000175:diagnosis / Q000628:therapy; D008175:Lung Neoplasms / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011013:Pneumonectomy; D011183:Postoperative Complications / Q000175:diagnosis / Q000628:therapy*; D015607:Stents; D013348:Subclavian Artery / Q000473:pathology; D013525:Surgical Instruments; D036542:Tomography, Spiral Computed
D020099:Coated Materials, Biocompatible