Coil Embolization Combined with Carotid-Subclavian Bypass for Treatment of Subclavian Artery Aneurysm

Abstract

Purpose:

To report 2 cases of proximal subclavian artery aneurysm treated with carotid-subclavian bypass and coil embolization.

Case Reports:

A subclavian artery aneurysm was discovered incidentally during presurgical coronary angiography in 2 men (72 and 63 years of age). Both patients underwent planned carotid endarterectomy, during which a carotid-subclavian bypass was created with a Dacron graft; the distal subclavian artery was also ligated. The aneurysm was completely excluded from the circulation by coil embolization in a separate procedure. The patients were discharged after 3 days with no adverse events. Magnetic resonance angiography at 6 months showed continued aneurysm exclusion in both cases. The patients continue to be well >1 year after treatment.

Conclusions:

Embolization with supraclavicular bypass represents a viable alternative to traditional thoracotomy and subclavian artery reconstruction for treatment of subclavian artery aneurysms.