title: Management of iatrogenic subclavian artery pseudoaneurysms.
abstract: BACKGROUND
  To report our experience in the management of iatrogenic subclavian artery pseudoaneurysms (SAPs).
  
  
  METHODS
  During a 6-year period, 5 patients were treated urgently for SAP.
  
  
  RESULTS
  Two patients presented with rupture, 2 with dyspnea, whereas 1 had unremitting severe pain. Three patients underwent preoperative computed tomography angiography and 2 digital subtraction angiography. Three patients were treated with an open surgical procedure, whereas 2 were managed by endovascular means. A combined supraclavicular and/or infraclavicular approach was used in 2 patients, whereas a midsternotomy was mandatory to achieve proximal control in one. A combined transfemoral and/or brachial approach was used in both patients treated endovascular. No perioperative deaths or procedure-related complications occurred. All symptoms were relieved, whereas the median hospital stay was 8 days. During a mean follow-up period of 20.4 ± 10 months, none of the patients needed any reintervention.
  
  
  CONCLUSIONS
  Iatrogenic SAPs constitute a clinical entity that may need surgical treatment, especially in the presence of symptoms. In relatively stable patients with no major compression issues, stenting could be considered as an adequate therapy for these situations. Open surgical repair should be considered when there is significant compression of adjacent structures or failure of the endovascular approach.
authors.affiliation: Division of Vascular Surgery, First Department of Surgery, Laiko General Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
authors.forename: Chris
authors.initials: C
authors.lastname: Klonaris
authors.affiliation: Division of Vascular Surgery, First Department of Surgery, Laiko General Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece. Electronic address: geokouv@gmail.com.
authors.forename: George
authors.initials: G
authors.lastname: Kouvelos
authors.affiliation: Division of Vascular Surgery, First Department of Surgery, Laiko General Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
authors.forename: Mikes
authors.initials: M
authors.lastname: Doulaptsis
authors.affiliation: Department of Vascular and Endovascular Surgery, Paracelsus Medical University, Nuernberg, Germany.
authors.forename: Athanasios
authors.initials: A
authors.lastname: Katsargyris
authors.affiliation: Department of Radiology, "Areteion" University Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
authors.forename: Achilleas
authors.initials: A
authors.lastname: Chatziioannou
mesh_terms: D000368:Aged; D017541:Aneurysm, False / Q000175:diagnosis / Q000601:surgery / Q000628:therapy*; D017542:Aneurysm, Ruptured / Q000175:diagnosis / Q000601:surgery / Q000628:therapy*; D015901:Angiography, Digital Subtraction; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000295:instrumentation; D057510:Endovascular Procedures / Q000295:instrumentation; D005260:Female; D006801:Humans; D007049:Iatrogenic Disease; D007902:Length of Stay; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D015607:Stents; D013348:Subclavian Artery / Q000000981:diagnostic imaging / Q000293:injuries / Q000601:surgery*; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D057772:Vascular System Injuries / Q000175:diagnosis / Q000601:surgery / Q000628:therapy*