Endovascular treatment with aortic endoprostheses for subclavian artery aneurysm secondary to late traumatic axillary-axillary arteriovenous fistula.
Vinicius Tadeu Ramos da Silva GrilloRodrigo Gibin JaldinFelipe Damascena RosaMariana Thais Silva SecondoRafael Elias Farres PimentaMatheus BertanhaMarcone Lima SobreiraWinston Bonetti YoshidaPublished in: Jornal vascular brasileiro (2022)
Traumatic arteriovenous fistulas (AVFs) involving the axillary and subclavian vessels are uncommon and account for 5 to 10% of all arterial traumas. The complex anatomy of this region makes treatment of this segment challenging. In this therapeutic challenge, we describe the case of a 73-year-old man, referred for progressive edema and ulceration involving the right upper limb and with a history of gunshot wound to the right infraclavicular region about 50 years previously. Angiotomography was performed and an axillary-axillary AVF was found, associated with tortuosity and aneurysmatic dilation of the subclavian artery downstream. He underwent endovascular intervention and a conical (monoiliac) 26 × 14 × 90 mm Braile® endoprosthesis was used in the aneurysmatic subclavian artery, posterior to the exit of the right vertebral artery and a 16 × 16 × 95mm Excluder® monoiliac endoprosthesis was placed overlapping the first prosthesis, showing a satisfactory result. Therefore, the possibility of successfully using aortic endoprostheses in an unusual and exceptional situation is described.
Keyphrases
- lymph node
- sentinel lymph node
- aortic dissection
- neoadjuvant chemotherapy
- ultrasound guided
- upper limb
- endovascular treatment
- spinal cord injury
- aortic valve
- randomized controlled trial
- early stage
- left ventricular
- multiple sclerosis
- coronary artery
- locally advanced
- squamous cell carcinoma
- postmenopausal women
- abdominal aortic aneurysm
- surgical site infection