| 摘要 |
Purpose: To report a case of iatrogenic subclavian artery perforation treated with
Vascular Stent-Graft.
Case Report: A 54-year-old married male was admitted to Chung Shin Hospital
with the chief complaint of severe sharp pain in his right clavicular region after a
traffic accident on April 6, 2009. Fracture of the right clavicle was diagnosed after
X-ray examination. The patient immediately underwent open reduction and internal
fixation (ORIF) with a Kirschner wire with an uneventful postoperative course. The
K-wire was removed 4 weeks later, on May 8, 2009. However, pain in the right
clavicular area recurred and lasted for almost one month. A repeated X-ray was
showed “Non-union of the right clavicular fracture”. The patient underwent a
“redo” open reduction (ORIF) on June 2, 2009. During the operation, the patient
sustained an accidental right subclavian artery injury resulting in active bleeding
and pseudo-aneurysm formation there of; he was transferred to Chung Shan
Medical University Hospital, and after CT angiography, he underwent endovascular
repair of his right subclavian artery perforation.
Results: The endovascular prosthesis (Fluency Plus Vascular Stent Graft 10 60
mm, Bard®) was successfully deployed at the site of the pseudoaneurysm via
ipsilateral femoral artery access. No signs of endograft occlusion, migration,
deformation, or fracrture have been observed during the follow-up period of eleven
months.
Conclusion: Endovascular repair of the subclavian artery injury may be an
acceptable alternative to other more invasive modes of therapy. A sufficiently long
follow-up, however, is needed to determine if the design of this endograft will resist
compression in this vascular location. |
