Neonatal stroke may occur silently. Identification of potential embolic pathways unique to the neonate is important when investigating the aetiology of infarction and arterial occlusion, and preventing further episodes. This is a case report of an infant with venous thrombus embolising across the foramen ovale causing cerebral infarction and subclavian ...

The purpose of this report is to explore angioplasty and stenting with cerebral embolic protection as a salvage procedure for a compromised carotid-subclavian bypass in the presence of antegrade vertebral artery flow. A 76-year-old woman with a carotid-subclavian bypass presented with graft infection. Failure of medical therapy to treat the ...

OBJECTIVE: To evaluate the efficacy of subclavian stenosis percutaneous transfemoral angioplasty (PTA)-treatment in patients with intermittent or complete subclavian steal syndrome (SSS), and coronary-subclavian steal syndrome (C-SSS) after left internal mammary artery-interventricular anterior artery (LIMA-IVA) by pass graft. METHODS: We studied 42 patients with coronary subclavian steal syndrome subdivided in ...

A patient with droopy shoulder syndrome (DSS) presented postural symptoms of venous compression of the left upper limb, in addition to those of traction at the brachial plexus. An antegrade phlebography clearly demonstrated impaired patency of the subclavian vein on neck extension. Recognition and management of the compromised venous drainage ...

Aberrant right subclavian artery (ARSA) aneurysms are rare but carry a high risk of rupture and require early elective treatment. The present report describes a 60-year-old man with an asymptomatic ARSA aneurysm for whom surgical treatment would have been associated with a high degree of risk. The ARSA aneurysm was ...

Athletes performing repetitive movements can develop arterial injuries. These are uncommon. We present a case of bilateral subclavian/axillary artery stenosis in a female patient referred to the rapid access chest pain clinic with a presumptive diagnosis of angina. Her symptoms were related to limb ischemia rather than cardiac insufficiency. Detailed ...

Subclavian artery puncture is an infrequent complication of subclavian vein cannulation. In spite of the limited ability to apply direct pressure to the bleeding vessel, significant hematoma or exsanguinating bleeding rarely occurs. This study was a retrospective chart review of a neonate who underwent extrapleural repair of a tracheo-esophageal fistula ...

Subclavian artery occlusive disease is usually secondary to persistent compression caused by thoracic outlet syndrome (TOS) and rarely due to focal atherosclerosis. Emboli from diseased vessel can flow retrograde to the vertebral or carotid arteries to produce ischemic infarct with or without neurological deficit. We are reporting two cases of ...

To introduce the case of a collegiate baseball player who suffered an atraumatic subclavian vein thrombosis. This case presents an opportunity to discuss the diagnosis and treatment of a 22-year-old male with a thrombosis of his right subclavian vein. Upper extremity deep venous thrombosis is an uncommon vascular problem, occurring ...

Rupture of subclavian artery aneurysms is rare. We report a case of a 67-year-old woman with malignant schwannoma who developed fatal repture of a subclavian artery aneurysm probably induced by a complication to the lung was demonstrated by CT, MRI, and radiography

BACKGROUND: Diffuse dermal angiomatosis is rare and usually considered a variant of reactive angioendotheliomatosis. It generally involves the extremities of patients with severe vascular disease and other comorbidities. Two patients with breast involvement have been described; however, neither had a relevant medical history or a vaso-occlusive disorder, but both had ...

Subclavian steal syndrome (SSS) is a clinical entity characterized by brachial and basilar insufficiency as a result of critical proximal subclavian artery stenosis or occlusion. We report a patient of giant hypervascular thyroid nodule presenting with features of SSS. The left hand ischemia and symptoms of vertebro-basilar artery in our ...

We report the case of a 1 1/2-year-old female child, who developed symptomatic hemorrhage from major aorto-pulmonary collaterals after surgery for Tetralogy of Fallot. During the course of embolization of the aorto-pulmonary collaterals, we discovered the presence of direct origin of the left internal and external carotid arteries from the ...

OBJECTIVE: Kommerell's diverticulum, which is a rare condition, is a congenital abnormality of the aortic arch. The strategy of surgical treatment for Kommerell's diverticulum has not been established. METHODS: Between 1994 and 2004, 6 patients underwent surgery for Kommerell's diverticulum at our institute. Diagnoses included right aortic arch with aberrant ...

BACKGROUND: A rapidly increasing number of thoracic aortic lesions are now treated by endoluminal exclusion by using stent grafts. Many of these lesions abut the great vessels and limit the length of the proximal landing zone. Various methods have been used to address this issue. We report our experience with ...

PURPOSE: Increased blood flow velocity in the contralateral vertebral artery (VA) is a common finding in subclavian steal syndrome, but its clinical relevance is not known. The aim of this study was to investigate whether the degree of velocity increase in the contralateral VA correlated with the severity of the ...

PURPOSE: Early and accurate diagnosis of peripheral atherosclerosis is of paramount importance for global management of patients with known coronary artery disease (CAD). We sought to retrospectively evaluate the clinical relevance of significant subclavian artery stenosis (SAS) and abdominal vessel stenosis or aneurysm (AVA) in patients undergoing coronary angiography. SUBJECTS ...

Aberrant subclavian artery (arteria lusoria) is a rare congenital anomaly that usually does not produce symptoms. Symptomatic patients require surgical intervention. The operative approach to correct this condition has been controversial. Herein, we describe surgical approaches to the aberrant right subclavian artery. From 2000 through 2004, 3 children and 1 ...

PURPOSE: With central venous catheterization, each additional vein puncture raises the risk of complications. We assessed the rate of failure and complications using a limiting rule whereby the number of needle passes for subclavian vein catheterization was restricted to three. METHODS: A prospective clinical trial was conducted between September 2001 ...

OBJECTIVE: Reverse flow in the internal thoracic artery (ITA) after coronary bypass surgery due to an occlusion or severe stenosis of the subclavian artery is a rare situation. Symptoms can be recurrent and intermittent angina pectoris in the case of a coronary-subclavian steal (CSSS) or-in addition with cerebral symptoms-in the ...

Blunt injury to the right subclavian artery is a rare complication of severe deceleration trauma often associated with significant morbidity and mortality. We describe an atypical presentation in a patient who sustained a traumatic avulsion of his right subclavian artery arising off the aortic arch. An interposition graft was used ...

Coronary-subclavian steal syndrome entails the reversal of blood flow in a previously constructed internal mammary artery coronary conduit, which produces myocardial ischemia. The most frequent cause of the syndrome is atherosclerotic disease in the ipsilateral, proximal subclavian artery. Although coronary-subclavian steal was initially reported to be rare, the increasing documentation ...

Pain occurs frequently in high-performance athletes and is most often due to musculoskeletal injury or strain. However, athletes who participate in sports that require highly frequent, repetitive limb motion can also experience pain from an underlying arteriopathy, which causes exercise-induced ischemia. We reviewed the clinical records and follow-up care of ...

A set of images in which a pacemaker lead replacement procedure was complicated by occlusion of the proximal subclavian vein is presented. However, this was not detected on venography performed before the procedure. Physicians should be aware of a more proximal occlusion of the subclavian vein while replacing pacemaker leads, ...

BACKGROUND: Ultrasound guidance for central and peripheral venous access has been proven to improve success rates and reduce complications of venous cannulation. Appropriately trained and experienced operators add significantly to diminished patient morbidity related to venous access procedures. We discuss a patient who required an arterial stent-graft to prevent arterial ...

Although open aneurysm repair remains the standard of care, the advent of endoluminal techniques and stent grafts has significant potential to improve treatment of aneurysms of the innominate and subclavian arteries. Regardless of the modality chosen, therapy must be individualized and treatments tailored on the basis of anatomic and etiologic ...

On diagnosis of Stanford type A acute aortic dissection with an aberrant right subclavian artery, emergency operation was performed. Aortic arch replacement was undertaken with additional 'elephant trunk' procedure to cover the entry site and decrease the blood flow through the false lumen. We consider this technique will become one ...

We have experienced three cases of retroesophageal right subclavian artery. Two cases were cadavers, and one case was a live human. In the two cadavers of a 68-year-old and a 76-year-old, respectively Japanese and European males, the right subclavian artery originated from the aorta after the aorta branched the right ...

A 69-year-old man with previous ascending aortic repair combined with valve replacement for an ascending aortic aneurysm presented with a type 2 thoracoabdominal aneurysm and a 4.4-cm aneurysm of the right subclavian artery. Because of the anatomic location of the aneurysm and his previous operation, an innominate to carotid artery ...

BACKGROUND: Subclavian artery dissection is a rare entity. It is usually associated with anomalous aortic vasculature. Only with trauma or catheterization procedures is subclavian artery dissection with normal aortic vasculature reported. PATIENT: We describe a patient with intrascapular pain, an occipital headache, and 3 distinct infarctions in the nervous system. ...

A 28-year-old man presented with transient speech disturbance and right hemiplegia. Computed tomography of the brain revealed a low-density area in the right cerebellum. A ventilation/perfusion lung scintiscan detected multiple perfusion defects in the both lungs and catheterization revealed pulmonary hypertension. Venography of the upper extremities revealed obstruction of the ...

An active otherwise healthy and middle-aged woman presented with left supraclavicular pulsation, right upper extremity claudication, and mild dysphagia. Evaluation revealed an aberrant right subclavian artery, Kommerell's diverticulum with aneurysmal degeneration, legamentum arteriosum completing vascular ring, and absent left pulmonary artery with multiple collateral supply to the left lung. She ...

BACKGROUND: The role of a J-type guidewire tip has been known to prevent vascular or cardiac wall damage. We hypothesized that the course of the guidewire may be influenced by the initial orientations of the J-type guidewire tip during the subclavian approach. The purpose of this study was to investigate ...

Cervical ribs are uncommon and occur in approximately 0.5-1% of the population. The authors describe a cadaver found to have a cervical rib with further compression by the dorsal scapular artery. This vessel originated from the third portion of the subclavian artery. No other anomalies were found in this specimen. ...

PURPOSE: To report our early experience with the endovascular placement of stacked Zenith main body extensions (cuffs) in the treatment of focal thoracic aortic pathology in high-risk patients. METHODS: Between January 2003 and May 2004, 6 patients (3 men; mean age 59 years, range 37-82) with focal aortic pathology underwent ...

Subclavian hemodialysis (HD) catheter placement under fluoroscopy with perforation of the superior vena cava (SVC) is a rare complication that needs to be recognized and treated appropriately. We report the case of a 47-year-old black woman under treatment for end-stage renal disease secondary to HIV-associated nephropathy who sustained an extravascular ...

Endovascular stent-graft placement has become a safe and effective treatment modality for various diseases of the distal aortic arch as well as of the descending aorta. However, its effectiveness may be limited by various kinds of endoleaks resulting in persistent or recurrent perfusion of the aneurysm sac. Subsequently, systemic pressurization ...

This case reports on an 81-year-old man with implanted dual-chamber pacemaker for binodal disease who required ventricular lead revision due to loss of ventricular capture. Successful placement of a new lead via the subclavian vein despite of high degree stenosis of the medial part of the vein is described using ...

A scaffold constructor lost consciousness at work, leading to emergency admission to our hospital. He had noted gradual worsening of exertional dyspnea over the previous 1 month. Chest radiography showed localized oligemia and enlarged hilar vessels. Pulmonary perfusion scintigraphy confirmed the existence of multiple perfusion defects, so a diagnosis of ...

This is a retrospective evaluation of the incidence of aberrant subclavian arteries (ASAs) and diverticula of Kommerell, as well as the occurrence and significance of associated aneurysms. Thoracic aortograms obtained during a 12.5-year period were reviewed, seeking the presence of aberrant right and left subclavian arteries (ARSAs/ALSAs), diverticula of Kommerell, ...

We report the unusual case of pulsatile tinnitus caused by muscular branches of the occipital artery, which developed to supply the distal vertebral artery after subclavian artery occlusion. Anatomical findings and options of endovascular treatment are discussed. To our knowledge, subclavian artery occlusion causing an objective tinnitus has not been ...

BACKGROUND: Cardiac pacemaker and defibrillator leads are inserted through extrathoracic subclavian venipuncture using ultrasound (US) guidance, but there can be complications. The purpose of this study was to investigate a safer and improved implanting procedure. METHODS AND RESULTS: Venipuncture guided by US with a 7.5 MHz convex transducer was performed ...

Right aortic arch with isolation of the left subclavian artery is a rare disorder. In this entity, the left subclavian artery has its origin from the pulmonary artery via the ductus arteriosus. We report an infant with an unbalanced atrioventricular septal defect, right aortic arch, bilateral ductus arteriosi and an ...

Current elective bypass procedures frequently involve placement of a left internal mammary artery (LIMA). Accordingly, there is an increased need to prove either preoperative adequacy or postoperative patency of this graft. We report a patient with a tortuous left subclavian artery inaccessible for any standard catheterization technique for LIMA opacification. ...

We report the unusual case of a 66-year-old alcoholic male who presented with acute arm ischemia 4 months following ipsilateral subclavian artery stenting. The patient had a petechial rash and Janeway lesions in the distribution of the affected subclavian artery. He had been treated for an infected dialysis graft 10 ...

The subclavian artery is a major constituent of the blood circulatory system. Its position in the root of the neck and its course through the interscalene triangle are significant. Its branches supply divers areas in the body from the brain to the thorax. This case report describes an unusual range ...

The recommended needle trajectory for the vertical infraclavicular brachial plexus block is anteroposterior, caudad to the middle of the clavicle. We studied the risk of pneumothorax and subclavian vessel puncture and the precision of this method by using magnetic resonance imaging in 20 adult volunteers. The trajectory aimed at the ...

Although patent ductus arteriosus (PDA) is the most common type of extracardiac shunt, aberrant PDA associated with other cardiac malformations as double brachiocephalic trunk and interrupted left subclavian artery is extremely rare. To the best of our knowledge, the literature contains no other report of a patient who has PDA ...

Isolation of the subclavian artery is a very rare vascular anomaly in which the subclavian artery does not communicate with the aortic arch but instead is connected to the pulmonary artery by the ductus arteriosus. The subclavian steal phenomenon from the vertebrobasilar system into the pulmonary and subclavian arteries is ...

Subclavian artery aneurysms are extremely rare, accounting for approximately 0.1% of peripheral artery aneurysms. We present a case of a proximal left subclavian arterial aneurysm in a patient status post previous coronary artery bypass grafting; the aneurysm was complicated by involvement of the left internal mammary artery that had been ...