The impact of technology on treatment of iatrogenic cervicothoracic vascular traumas: a study of two cases three decades apart and a review of the literature

Jornal Vascular Brasileiro
Victor BilmanArno von Ristow

Abstract

Complications such as pseudoaneurysms (PA) related to cervicothoracic venous access can be devastating. In this article, we present two similar cases in which technological advances impacted diagnosis, treatment, and results. Both patients developed massive PA after deep venous puncture attempts. The first case occurred in 1993 and was diagnosed by a duplex scan that revealed a large PA originating from the right subclavian artery. The artery was approached by median sternotomy with supraclavicular extension. The PA originated from the thyrocervical trunk and was treated with simple ligation. The second case was in 2017. Angiotomography revealed a PA originating in the vertebral artery, which was treated with endovascular techniques, maintaining vessel patency. Both patients progressed satisfactorily, despite quite different approaches. Cervicothoracic vascular lesions represent a diagnostic and therapeutic challenge, where the risk of rupture is high. Technological advances have reduced the risks involved in management of vascular injuries with difficult surgical access.

References

Jun 18, 2002·European Journal of Radiology·Mutlu CihangirogluHadi Uysal
Dec 12, 2002·Vascular and Endovascular Surgery·Thomas R BernikToufic Safa
Nov 12, 2005·Acta Neurologica Scandinavica·J Inamasu, B H Guiot
Aug 16, 2008·Journal of Vascular Surgery·Marie-Christine GuilbertJean-François Blair
Aug 15, 2014·Intensive Care Medicine·Se Hwan Kwon, Joo Hyeong Oh
Mar 17, 2015·Annals of Vascular Surgery·Gabriel Cristian Inaraja PérezPablo Cabezudo García

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