title: Iatrogenic Subclavian Artery Perforation Rescued by Operator-Modified Graft Stent.
abstract: Subclavian artery (SCA) perforation is a rare complication while performing SCA intervention. In our present report, a 73-year-old female, with stenosis of the left SCA and situs inversus, presented with exercise-induced left arm weakness. The SCA stenosis was treated with direct stenting with a balloon-expansible Express LD 10×25 mm stent. However, it caused iatrogenic SCA perforation and hemothorax. The perforation was sealed by endovascular repair with operator-modified Endurant II graft stent, which complicated with occlusion of left common carotid artery. And, the carotid artery was rescued by another stent. The graft stent, which was originally designed for abdominal aortic aneurysm, can be modified to suitable length and take as a rescue stent of large vessel with iatrogenic perforation. Due to strong radial force of graft stent, preservation of large side branches should been watched out.
authors.affiliation: Divisions of Interventional Cardiology and Adult Cardiac Surgery, Cardiovascular Center, Taichung Veterans General Hospital, Taichung, Taiwan, R.O.C.|School of Medicine, National Yang-Ming University, Taipei, Taiwan, R.O.C.
authors.forename: Chih Hung
authors.initials: CH
authors.lastname: Lai
authors.affiliation: Divisions of Interventional Cardiology and Adult Cardiac Surgery, Cardiovascular Center, Taichung Veterans General Hospital, Taichung, Taiwan, R.O.C.|School of Medicine, National Yang-Ming University, Taipei, Taiwan, R.O.C.
authors.forename: Chung Lin
authors.initials: CL
authors.lastname: Tsai
authors.affiliation: Divisions of Interventional Cardiology and Adult Cardiac Surgery, Cardiovascular Center, Taichung Veterans General Hospital, Taichung, Taiwan, R.O.C.|School of Medicine, National Yang-Ming University, Taipei, Taiwan, R.O.C.
authors.forename: Wei Chun
authors.initials: WC
authors.lastname: Chang
authors.affiliation: Divisions of Interventional Cardiology and Adult Cardiac Surgery, Cardiovascular Center, Taichung Veterans General Hospital, Taichung, Taiwan, R.O.C.|School of Medicine, National Yang-Ming University, Taipei, Taiwan, R.O.C.
authors.forename: Chieh Shou
authors.initials: CS
authors.lastname: Su
authors.affiliation: Divisions of Interventional Cardiology and Adult Cardiac Surgery, Cardiovascular Center, Taichung Veterans General Hospital, Taichung, Taiwan, R.O.C.|School of Medicine, National Yang-Ming University, Taipei, Taiwan, R.O.C. wenliengleevghtc@gmail.com.
authors.forename: Wen Lieng
authors.initials: WL
authors.lastname: Lee
mesh_terms: D000368:Aged; D017536:Carotid Artery, Common; D016893:Carotid Stenosis / Q000209:etiology / Q000628:therapy*; D005260:Female; D006491:Hemothorax / Q000209:etiology; D006801:Humans; D007049:Iatrogenic Disease; D007431:Intraoperative Complications / Q000209:etiology / Q000628:therapy*; D016879:Salvage Therapy / Q000295:instrumentation*; D015607:Stents / Q000009:adverse effects; D013348:Subclavian Artery / Q000293:injuries* / Q000473:pathology / Q000601:surgery
keywords: Subclavian artery stenosis; graft stent; peripheral angioplasty, hemothorax; subclavian artery perforation