Surgical treatment of subclavian artery aneurysms
Salem, A., Salem, M., Salem, S., Moustafa, S. (2021). Surgical treatment of subclavian artery aneurysms. EKB Journal Management System, 27(6), 1582-1591. doi: 10.21608/zumj.2021.65011.2149
Amr Mohamed Salem; Mohamed Salem; sherif Mohamed Salem; Sameh Moustafa. "Surgical treatment of subclavian artery aneurysms". EKB Journal Management System, 27, 6, 2021, 1582-1591. doi: 10.21608/zumj.2021.65011.2149
Salem, A., Salem, M., Salem, S., Moustafa, S. (2021). 'Surgical treatment of subclavian artery aneurysms', EKB Journal Management System, 27(6), pp. 1582-1591. doi: 10.21608/zumj.2021.65011.2149
Salem, A., Salem, M., Salem, S., Moustafa, S. Surgical treatment of subclavian artery aneurysms. EKB Journal Management System, 2021; 27(6): 1582-1591. doi: 10.21608/zumj.2021.65011.2149

Surgical treatment of subclavian artery aneurysms

Zagazig University Medical Journal
Article 707, Volume 27, Issue 6, November 2021, Page 1582-1591  XML PDF (482.4 K)
Document Type: Original Article
DOI: 10.21608/zumj.2021.65011.2149
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Authors
Amr Mohamed Salem email 1; Mohamed Salemorcid 2; sherif Mohamed Salem3; Sameh Moustafa4
1Experimental and Clinical Surgery Department , Medical Research Institute , Alexandria University , Alexandria, Egypt
2Vascular surgery unit, department of surgery, faculty of medicine , Alexandria university, Egypt
3Department of Neurosurgery, Faculty of Medicine, Alexandria University, Egypt
4Vascular Surgery Unit, Department of Surgery, Faculty of Medicine, Alexandria University , Egypt.
Abstract
Background: Subclavian artery aneurysms (SAAs) are uncommon aneurysms.SAA is potentially serious disease due to complications.
Objective: to evaluate the surgical treatment of SAAs and its complications.
Methods: Fifteen patients with SAAs: 13 patients (86.67%) had extrathoracic (ET) aneurysms and two patients (13.33%) had intrathoracic (IT) aneurysms. Thoracic outlet syndrome (TOS) was presented in 8 patients (53.33%), while, atherosclerosis was presented in 7patients (46.67%). Laboratory & radiological studies were done. All patients were treated surgically.
Results: In 13 patients with extrathoracic aneurysms, a supraclavicular approach to the subclavian artery was used in (6/13, 46.15%), supraclavicular and infraclavicular approach was used in (7/13, 53.85%) cases. After excision of the aneurysm, graft interposition using (PTFE) and saphenous vein graft bypass were done in (6/13, 46.15% & 5/13 , 38.46 %) patients respectively. In two patients (2/13, 15.38 %), aneurysmal excision and end to end anastomosis were done. While in two patients with intrathoracic aneurysms, a combined left thoracotomy and supraclavicular approach was used. Common carotid-subclavian bypass using Dacron graft was done. In (6/8, 75 %) of patients with TOS, decompression was performed before arterial reconstruction. In three (37.50 %) patients with cervical rib, the cervical rib was resected. In three patients (37.50 %) with scalene syndrome, scalenectomy of the scalenus anterior muscle was done. In two patients (2/8, 25 %) with brachial artery embolism, embolectomy was done.
Conclusions: Early intervention was needed, especially in distal SAAs, because of the risk of thrombo-embolic complications. Open repair is sill the gold standard intervention for SAA.
Keywords
Subclavian artery aneurysm(SAA); thoracic outlet syndrome; intrathoracic SAA; extrathoracic SAA; open surgical repair. 
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