Endovascular Treatment of Subclavian Artery Pseudoaneurysm

In recent years, endovascular treatment of subclavian artery pseudoaneurysm (SAP) has been recommended by many experts. The aim of this study is to evaluate the safety and efficacy of the endovascular treatment of SAP, and to introduce our experience in the diagnosis and treatment of SAP.

A total of 8 consecutive patients with SAP were treated with endovascular treatment in our hospital between 2010 and 2018. We retrospectively reviewed the patients' clinical characteristics, physical examinations findings, diagnostic imaging results, endovascular treatment, clinical outcome, and follow-up results.

All the 8 patients received endovascular treatment with covered stents initially. The technical success rate was 87.5% (7/8). In 1 patient with severe tortuosity of the proximal subclavian artery, the stent could not be released through the femoral artery approach in the primary operation but was successfully released via the brachial artery approach in the secondary operation. No complications occurred in the perioperative period. All the symptoms and signs were significantly relieved. During a follow-up of 4.5-84.5 months (average 31.5 months), 1 patient developed an endoleak 4 months after operation and reintervention was attempted but failed. No adverse events occurred in other patients during the follow-up period.

Endovascular treatment of SAP is safe and effective, and should be used as a first-line treatment. Stent placement through the brachial artery approach is recommended for SAP with severe proximal vascular tortuosity.