alexa Endovascular Treatment of Traumatic Pseudo Aneurysm of the Supraescapular Artery | Open Access Journals
ISSN: 2329-6925
Journal of Vascular Medicine & Surgery
Make the best use of Scientific Research and information from our 700+ peer reviewed, Open Access Journals that operates with the help of 50,000+ Editorial Board Members and esteemed reviewers and 1000+ Scientific associations in Medical, Clinical, Pharmaceutical, Engineering, Technology and Management Fields.
Meet Inspiring Speakers and Experts at our 3000+ Global Conferenceseries Events with over 600+ Conferences, 1200+ Symposiums and 1200+ Workshops on
Medical, Pharma, Engineering, Science, Technology and Business

Endovascular Treatment of Traumatic Pseudo Aneurysm of the Supraescapular Artery

Méndez JC1*, Ana P2, Eduardo F1 and Javier B2

 

1Interventional Neuroradiology Unit, Department of Radiology, University Hospital Ramón y Cajal, Madrid, Spain

2Vascular and Interventional Radiology Unit, Department of Radiology, University Hospital Ramón y Cajal, Madrid, Spain

*Corresponding Author:
Méndez JC
Interventional Neuroradiology Unit
Department of Radiology, University Hospital
Ramón y Cajal, Madrid, Spain
Tel: 911256407
E-mail:
[email protected]

Received Date: July 16, 2015; Accepted Date: January 21, 2016; Published Date: January 29, 2016

Citation: Méndez JC, Ana P, Eduardo F, Javier B (2016) Endovascular Treatment of Traumatic Pseudo Aneurysm of the Supraescapular Artery. J Vasc Med Surg 4:249. doi: 10.4172/2329-6925.1000249

Copyright: © 2016 Méndez JC, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Visit for more related articles at Journal of Vascular Medicine & Surgery

Abstract

Traumatic pseudoaneuryms of the supraescapular artery have been rarely reported. Management modalities poorly defined. Treatment options include simple observation, surgical intervention, and endovascular embolization alone or followed by surgery. We present a case of a traumatic pseudoaneurysm in the supraescapular artery in a 80-year-old woman which was succesfully treated with endovascular embolization.

Keywords

Pseudo aneurysm; Supraescapular artery; Endovascular treatment

Concept

An 80-year-old woman with an atrial fibrillation has been treated with oral anticoagulant therapy. She presented with a history of upper right back pain after suffering a fall two months before with right clavicle fracture and multiple righ side rib fractures. Physical examination revealed a large, palpable, right sided, upper back subcutaneous heamatoma. A computed tomography (CT) scan revealed an extensive haematoma in the subcutaneous soft tissue of the right posterior chest wall, with a contrast-enhanced nodule into it, suggesting acute bleeding or pseudo aneurysm (Figure 1).

vascular-medicine-surgery-contrast-enhanced-hematoma

Figure 1: Axial contrast-enhanced CT scan shows a huge hematoma in the right posterior chest wall with a pseudoaneurysm enhanced during arterial phase of intravenous contrast agent injection.

Selective right subclavian angiography demonstrated a pseudoaneurysm in the right supraescapular artery (Figure 2A). A decision was made to treat the pseudoaneurysm with selective embolization. A 6-french, 90 cm-long sheat (Arrow International, Reading, PA, USA) was placed in the right subclavian artery, and the tip of a 5-French diagnostic catheter (JB-2, Cordis Corporation, Bridgewater, NJ, USA) was positioned in the proximal thyrocervical trunk as guiding catheter. A Rebar-14 microcatheter (Covidien, Irvine, CA, USA) with a 0.014-inch micro-guide wire (Synchro 14, Stryker, Kalamazoo, MI, USA) was advanced in a coaxial fashion through the 5-French catheter to reach the supraescapular artery distal to the pseudoaneurysm.

vascular-medicine-surgery-angiography-arterial-extravasation

Figure 2A: Digital subtraction angiography in the arterial phase shows contrast extravasation from the right supraescapular artery, consistent with pseudo aneurysm.

A total of 4 ml. of high-density liquid embolic agent (Onyx 500-HD, Covidien, Irvine, CA, USA) were injected through the microcatheter, and the pseudoaneurysm was succesfully occluded (Figure 2B). The patient was discharged two weeks after the procedure, and CT 30 days after injury showed almost complete resolution of the haematoma. Twelve months later, a control colour Doppler sonography confirmed the complete occlusion of the pseudaneurysm.

vascular-medicine-surgery-angiography-cervical-trunk

Figure 2B: Selective angiography of right cost cervical trunk after embolization shows complete obliteration of the pseudo aneurysm.

The suprascapular artery (or transverse scapular artery) is usually a branch of the thyrocervical trunk of the subclavian artery that supplies the supraspinatus, sternocleidomastoid and subclavius muscles. Some reports have described an abnormal origin of the suprascapular artery [1].

Pseudoaneurysms of subclavian or axillary arteries or their branches have been described as a sequelae of trauma or iatrogenic injuries. In these cases, treatment options include simple observation, surgical intervention, and endovascular embolization alone or followed by surgery [2,3].

Traumatic pseudoaneuryms of the supraescapular artery have been rarely described, with only one previous case reported. Prater et al. [4] described a left supraescapular artery traumatic pseudoaneurysm which they treated with coil occlusion of the parent artery to prevent backflow from collateral vessels. Zardi et al. [5], described an non-traumatic aneurysm of the right supraescapular artery arising directly from the subclavian artery, which was succesfully treated with endovascular embolization of the aneurysm, the parent artery and their collaterals with high-viscosity agent (Onyx Hd-500).

Selective embolization of pseudoaneuryms with Onyx has proven to be an effective technique for achieving complete occlusion of pseudoaneurysms, with no recurrences during follow-up [6,7]. In our experience, if complete occlusion of the aneurysm is achieved with Onyx, it is no neccesary to oclude both the aneurysm and all the collaterals at one time to prevent aneurysm recanalization. Intraaneurysmal controlled injection of high-viscosity Onyx allows total pseudoaneurysm occlusion and parent artery preservation in most cases, with no further risk of aneurysm recanalization from collateral arteries.

References

Select your language of interest to view the total content in your interested language
Post your comment

Share This Article

Relevant Topics

Article Usage

  • Total views: 7968
  • [From(publication date):
    February-2016 - Sep 20, 2017]
  • Breakdown by view type
  • HTML page views : 7895
  • PDF downloads :73
 

Post your comment

captcha   Reload  Can't read the image? click here to refresh

Peer Reviewed Journals
 
Make the best use of Scientific Research and information from our 700 + peer reviewed, Open Access Journals
International Conferences 2017-18
 
Meet Inspiring Speakers and Experts at our 3000+ Global Annual Meetings

Contact Us

Agri, Food, Aqua and Veterinary Science Journals

Dr. Krish

[email protected]

1-702-714-7001 Extn: 9040

Clinical and Biochemistry Journals

Datta A

[email protected]

1-702-714-7001Extn: 9037

Business & Management Journals

Ronald

busines[email protected]

1-702-714-7001Extn: 9042

Chemical Engineering and Chemistry Journals

Gabriel Shaw

[email protected]

1-702-714-7001 Extn: 9040

Earth & Environmental Sciences

Katie Wilson

[email protected]

1-702-714-7001Extn: 9042

Engineering Journals

James Franklin

[email protected]

1-702-714-7001Extn: 9042

General Science and Health care Journals

Andrea Jason

[email protected]

1-702-714-7001Extn: 9043

Genetics and Molecular Biology Journals

Anna Melissa

[email protected]

1-702-714-7001 Extn: 9006

Immunology & Microbiology Journals

David Gorantl

[email protected]

1-702-714-7001Extn: 9014

Informatics Journals

Stephanie Skinner

[email protected]

1-702-714-7001Extn: 9039

Material Sciences Journals

Rachle Green

[email protected]

1-702-714-7001Extn: 9039

Mathematics and Physics Journals

Jim Willison

[email protected]

1-702-714-7001 Extn: 9042

Medical Journals

Nimmi Anna

[email protected]

1-702-714-7001 Extn: 9038

Neuroscience & Psychology Journals

Nathan T

[email protected]

1-702-714-7001Extn: 9041

Pharmaceutical Sciences Journals

John Behannon

[email protected]

1-702-714-7001Extn: 9007

Social & Political Science Journals

Steve Harry

[email protected]

1-702-714-7001 Extn: 9042

 
© 2008-2017 OMICS International - Open Access Publisher. Best viewed in Mozilla Firefox | Google Chrome | Above IE 7.0 version
adwords