Endovascular treatment with aortic endoprostheses for subclavian artery aneurysm secondary to late traumatic axillary-axillary arteriovenous fistula

• Autor(a) principal: Grillo, Vinicius Tadeu Ramos da Silva [UNESP]
• Data de Publicação: 2021
• Outros Autores: Jaldin, Rodrigo Gibin [UNESP], Rosa, Felipe Damascena [UNESP], Secondo, Mariana Thais Silva [UNESP], Pimenta, Rafael Elias Farres [UNESP], Bertanha, Matheus [UNESP], Sobreira, Marcone Lima [UNESP], Yoshida, Winston Bonetti [UNESP]
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Repositório Institucional da UNESP
• Texto Completo: http://dx.doi.org/10.1590/1677-5449.210016; http://hdl.handle.net/11449/230458
• topic: Arteriovenous fistula; Endovascular procedure; Subclavian artery; Vascular system injuries

Traumatic arteriovenous fistulas (AVFs) involving the axillary and subclavian vessels are uncommon and account for 5 to 10% of all arterial traumas. The complex anatomy of this region makes treatment of this segment challenging. In this therapeutic challenge, we describe the case of a 73-year-old man, referred for progressive edema and ulceration involving the right upper limb and with a history of gunshot wound to the right infraclavicular region about 50 years previously. Angiotomography was performed and an axillary-axillary AVF was found, associated with tortuosity and aneurysmatic dilation of the subclavian artery downstream. He underwent endovascular intervention and a conical (monoiliac) 26 × 14 × 90 mm Braile® endoprosthesis was used in the aneurysmatic subclavian artery, posterior to the exit of the right vertebral artery and a 16 × 16 × 95mm Excluder® monoiliac endoprosthesis was placed overlapping the first prosthesis, showing a satisfactory result. Therefore, the possibility of successfully using aortic endoprostheses in an unusual and exceptional situation is described.