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Case Reports
. 2023 Nov 19;59(11):2038.
doi: 10.3390/medicina59112038.

Subclavian Artery Pseudoaneurysm Following Bedside Temporary Hemodialysis Catheter Insertion: A Case Report

Sang-Woo Kim  1 , In-Chul Nam  1 , Doo-Ri Kim  1 , Jeong-Jae Kim  1 , Sung-Eun Park  2
Affiliations
Case Reports

Subclavian Artery Pseudoaneurysm Following Bedside Temporary Hemodialysis Catheter Insertion: A Case Report

Sang-Woo Kim et al. Medicina (Kaunas). .

Abstract

A pseudoaneurysm of the subclavian artery following central venous catheter placement is a rare but potentially fatal complication that often requires surgical intervention. However, surgical repair of the subclavian artery remains challenging. Herein, we report the case of a male patient undergoing hemodialysis who developed a pseudoaneurysm of the subclavian artery after a bedside central vein catheter placement. Hemostasis was successfully achieved by selecting the pseudoaneurysm using a microcatheter. At the 10-month follow-up, the pseudoaneurysm was completely excluded, and the patient was in a stable condition. The patient underwent native arteriovenous fistula creation and hemodialysis. Endovascular treatment could be an effective nonsurgical treatment for subclavian artery pseudoaneurysms and has been attempted as a first-line treatment option.

Keywords: embolization; pseudoaneurysm; subclavian; temporary hemodialysis catheter.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
A 77-year-old man shows an irregular-shaped pseudoaneurysm at the most proximal portion of the subclavian artery, extending to the mediastinum. (A) The 3D volume rendering image shows a pseudoaneurysm (white arrow). (B) The coronal reformatted contrast-enhanced CT demonstrates the pseudoaneurysm (white arrow) extending to the mediastinum. Note the subclavian artery (black asterisk). (C) The sagittal reformatted contrast-enhanced CT demonstrates the pseudoaneurysm (white arrow) arising from the subclavian artery (black dagger). Note the common carotid artery (black asterisk). (D) The 3D volume rendering image shows an irregular-shaped pseudoaneurysm. The volume of pseudoaneurysm is approximately 15 cc.
Figure 2
Figure 2
Conventional angiography and coil with N-butyl cyanoacrylate (NBCA) embolization. (A) Conventional angiography shows pseudoaneurysm (white arrow) at subclavian artery, extending to mediastinum. (B) Embolization is performed using multiple coils. (C) Complete embolization is performed using multiple coils and NBCA injection. Note the partial extrusion of NBCA cast (white asterisk) into arterial lumen. (D) Final angiography shows patent arterial flow and stable state of extruded cast material.
Figure 3
Figure 3
Chest radiographs acquired 10 months after the procedure show stable state of coils and N-butyl cyanoacrylate (NBCA) cast material.
See this image and copyright information in PMC

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