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Review
. 2019 Jan 1;58(1):73-78.
doi: 10.2169/internalmedicine.1451-18. Epub 2018 Aug 24.

Localized Right Subclavian Artery Dissection Detected by Accident on an Ultrasound Examination: A Case Report and Literature Review

Hidenori Onishi  1   2 , Osamu Yamamura  3   4 , Seiya Matsuo  5 , Tokuharu Tanaka  6 , Satoshi Daitoku  7 , Shizuka Konokawa  8 , Hiromasa Tsubouchi  9 , Hiroshi Chiba  10 , Maiko Sone  11 , Bunji Kaku  12 , Souichi Enomoto  2 , Tami Yamamoto  13 , Youichirou Hashimoto  14 , Tadanori Hamano  2 , Hiroyuki Hayashi  2 , Hidekazu Terasawa  4
Affiliations
Review

Localized Right Subclavian Artery Dissection Detected by Accident on an Ultrasound Examination: A Case Report and Literature Review

Hidenori Onishi et al. Intern Med. .

Abstract

Right subclavian artery dissection was detected in a 78-year-old female victim of the Kumamoto earthquake during a carotid artery ultrasound examination. She was subsequently taken to hospital and diagnosed with localized subclavian artery dissection (LSAD) by contrast-enhanced computed tomography. There have been no previous reports of LSAD detected at a medical checkup. LSAD may progress and become severe, even in asymptomatic patients or patients with mild symptoms, and careful long-term follow-up is therefore required in all patients diagnosed with LSAD.

Keywords: Kumamoto earthquake; carotid artery ultrasound examination; localized right subclavian artery dissection.

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Conflict of interest statement

The authors state that they have no Conflict of Interest (COI).

Figures

Figure 1.
Figure 1.
The carotid artery ultrasound examination (B-mode). B-mode ultrasound revealed an approximately 4-cm localized dissection with a false lumen from the root of the right subclavian artery to the axillary artery. The flap was slightly thicker with no motion. A: Long-axis view: right subclavian artery true lumen (yellow arrow), flap (red arrow), false lumen (white arrow). B: Short-axis view: right subclavian artery true lumen (yellow arrow), false lumen (red arrow).
Figure 2.
Figure 2.
Carotid artery ultrasound examination (color mode). A: Color mode revealed an entry tear located at the brachiocephalic artery in the long-axis view. Right subclavian artery true lumen (yellow arrow), flap (red arrow), entry (blue arrow), false lumen (white arrow). Right subclavian artery true lumen (yellow arrow), flap (red arrow), entry (blue arrow), false lumen (white arrow). B: Color mode re-entry tear located at the axillary artery in the long-axis view. Right subclavian artery true lumen (yellow arrow), flap (red arrow), false lumen (white arrow). B: Right subclavian artery true lumen (yellow arrow), re-entry (blue arrow), flap (red arrow), false lumen (white arrow).
Figure 3.
Figure 3.
Contrast-enhanced computed tomography scan 1. Transverse image of subclavian artery dissection and flaps (arrow).
Figure 4.
Figure 4.
Contrast-enhanced computed tomography scan 2. Localized dissection was detected from the right subclavian artery to the proximal axillary artery (arrow). A: Coronal-plane image (front). B: Coronal-plane image (oblique position).
See this image and copyright information in PMC

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