Endovascular Repair of Intraoperative Penetrating Injury to the Subclavian Vein: Case Report, Technical Considerations and Literature Review.
Dimitrios A Chatzelas, Apostolos G Pitoulias, Theodosia N Zampaka et al.
✦ AI-curated · Sources linked
Case in brief
A 60-year-old woman sustained an iatrogenic left subclavian vein injury during lateral cervical lymph node dissection for invasive thyroid carcinoma. Open attempts to control bleeding were unsuccessful because the injury was deep and extensive. Emergency endovascular placement of an 11 × 50 mm self-expanding stent-graft immediately excluded the injury. She recovered without complication and was discharged on therapeutic-dose direct oral anticoagulation. Duplex ultrasound showed stent-graft patency; CT venography at 12 months showed no thrombosis, stenosis, or migration, and she remained asymptomatic with a patent graft at 2 years.
What made this case unusual
The injury occurred intraoperatively, and open hemostasis failed; rapid endovascular stent-graft repair provided durable exclusion of the subclavian venous injury.
Diagnostic / clinical pearl
When open control of a deep subclavian venous injury is unsuccessful, emergency endovascular stent-graft repair may achieve immediate exclusion; follow-up in this case documented durable patency.