Spontaneous Dissecting Subclavian Aneurysm — A Case Report

Abstract

Dissecting aneurysms of the peripheral arteries are rare lesions. In 1969, Wychulis reviewed the medical literature and found one hundred and eight reported cases of primary dissecting aneurysms of peripheral arteries and added two cases of his own.¹ Of these, only one case of primary dissecting aneurysm of the subclavian artery was reported. This one was associated with trauma.

In 1968, Persaud reported the first case of dissecting aneurysm of the subclavian artery secondary to idiopathic cystic medial necrosis (ICMN).² Later in 1968, Fee reported a case of dissecting aneurysms of both subclavian arteries also associated with ICMN.³

To our knowledge, there has been no reported cases of primary dissecting aneurysms of the subclavian artery occurring spontaneously without associated recognizable trauma, ICMN, syphilis, or congenital defects. Such a case is the subject of this report. Plain x-rays and angiographic presentation, intra-operative appearance, and management are presented. Histologic findings are briefly discussed.