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锁骨骨折继发创伤后左锁骨下动脉假性动脉瘤:一例报告及文献综述

Post-Traumatic Left Subclavian Artery Pseudoaneurysm Secondary to Clavicular Fracture: A Case Report and Literature Review.

作者信息

Wojtyś Małgorzata Edyta, Skórka Patryk, Kordykiewicz Dawid, Falkowski Aleksander, Jakubowska-Grzeszyk Joanna, Wójcik Janusz, Wojtys Edward Michael

机构信息

Department of Thoracic Surgery and Transplantation, Pomeranian Medical University in Szczecin, Alfreda Sokołowskiego 11, 70-891 Szczecin, Poland.

Department of General, Dental and Interventional Radiology, Pomeranian Medical University in Szczecin, Powstańców Wielkopolskich 72, 70-111 Szczecin, Poland.

出版信息

Biomedicines. 2025 Jan 14;13(1):187. doi: 10.3390/biomedicines13010187.

Abstract

Subclavian artery pseudoaneurysms are rare but potentially life-threatening vascular injuries frequently associated with trauma such as clavicle fractures. In this paper we describe the case of a 49-year-old male who developed a post-traumatic pseudoaneurysm of the subclavian artery after a bicycle accident. The diagnosis was delayed due to non-specific symptoms and an initially missed aneurysm on computed tomography imaging. Persistent pain, swelling, and erythema in the subclavian region prompted further detailed diagnostics, which ultimately revealed the pseudoaneurysm. The patient was successfully treated with endovascular stent-graft implantation. We screened the PubMed database to identify similar cases managed exclusively through endovascular intervention. Reports of iatrogenic pseudoaneurysms and those treated with open surgery were excluded. Variables such as time to diagnosis, clinical presentation, features of pseudoaneurysms, and complications were analyzed to highlight the role of endovascular techniques as a minimally invasive and effective treatment option. These cases pose both a diagnostic and a therapeutic challenge, as early recognition of symptoms is crucial to prevent serious complications including thrombosis, neurological deficits, and even limb loss.

摘要

锁骨下动脉假性动脉瘤罕见,但为潜在危及生命的血管损伤,常与锁骨骨折等创伤相关。本文描述了一名49岁男性病例,该患者在一次自行车事故后发生了创伤后锁骨下动脉假性动脉瘤。由于症状不特异且计算机断层扫描成像最初漏诊了动脉瘤,诊断被延误。锁骨下区域持续的疼痛、肿胀和红斑促使进一步详细诊断,最终发现了假性动脉瘤。患者通过血管内支架植入术成功治疗。我们筛查了PubMed数据库以识别仅通过血管内干预处理的类似病例。排除了医源性假性动脉瘤及接受开放手术治疗的病例报告。分析了诊断时间、临床表现、假性动脉瘤特征及并发症等变量,以突出血管内技术作为一种微创且有效治疗选择的作用。这些病例带来了诊断和治疗两方面的挑战,因为早期识别症状对于预防包括血栓形成、神经功能缺损甚至肢体丧失在内的严重并发症至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aaff/11761245/c79dc93093d7/biomedicines-13-00187-g001.jpg

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