Subclavian and thyrocervical trunk pseudoaneurysms are rare pathologies and even more so when they occur simultaneously. Treatment of these vascular injuries can be done endovascularly or with open surgery. We present a novel two-stage, hybrid open and endovascular approach to the management of a healthy 41-year-old man with no personal or family history of connective tissue disorders, who presented with subclavian branch and thyrocervical trunk pseudoaneurysms complicated by brachial artery occlusion. The pseudoaneurysms were treated with microvascular plug deployment, followed by subclavian artery covered stenting, with treatment of the brachial occlusion via open thrombectomy with patch angioplasty. The patient recovered without any complications.

Subclavian artery pseudoaneurysm (PSA) is a rare complication arising from transaxillary Impella device placement during high-risk percutaneous coronary intervention (PCI). Despite the increasing prevalence of Impella use, literature addressing this complication is scarce. This case emphasizes the limited existing evidence on subclavian artery PSA and highlights the importance of recognizing it as a potential risk. With high-risk PCI and Impella use gaining popularity, understanding this complication is crucial for early detection and appropriate management. A 62-year-old male with a past medical history of type II diabetes mellitus, peripheral artery disease, hypertension, and chronic tobacco use presents with recurrent episodes of exertional chest pain and dyspnea. Initial workup with an electrocardiogram showed ST-segment elevations in the anteroseptal leads. The patient underwent right- and left-sided cardiac catheterization, which revealed severe stenosis of the left anterior descending artery and findings of cardiogenic shock. The patient required mechanical circulatory support with a percutaneous left ventricular assist device during the procedure; this was placed via transaxillary approach due to the patient having peripheral artery disease in bilateral femoral arteries. The patient had a complicated clinical course, but the patient\'s clinical picture slowly improved, and the percutaneous left ventricular assist device was removed. Roughly six weeks after the removal of the device, the patient developed a large fluid collection in the chest wall anterior to the left shoulder. Imaging revealed a ruptured left distal subclavian artery PSA. The patient was promptly taken to the catheterization laboratory and a covered stent was deployed over the site of the PSA. Repeat angiography revealed brisk flow through the left subclavian artery into the axillary artery with no extravasation into the chest wall.

The vascular involvement in patients with Behcet\'s disease is defined as vascular Behcet\'s disease, which can greatly influence the prognosis. However, there are few reports on endovascular treatment (EVT) for subclavian pseudoaneurysms with long-term prognosis over 10 years. We present the case of a 42-year-old man with left subclavian artery pseudoaneurysm due to vascular Behcet\'s disease who was treated with EVT along with immunosuppressive therapies. Subsequently, 8 years after, the aneurysm recurred in the stent with stent fracture. Therefore, additional EVT was performed. We present the details of the patient\'s clinical course over 10 years after the EVT. .

We present a rare case of a 10-cm right subclavian artery pseudoaneurysm, with slow growth over 4 years after a traumatic fracture of the right clavicle. The patient had multiple prior endovascular attempts of embolization and stenting at other hospitals; despite this the pseudoaneurysm continued to grow and caused mass effect and neurologic symptoms. We present our open approach for the repair and a review of literature.

A young male patient presented at a tertiary care hospital with cold and bluish left upper limb accompanied with digital gangrene arousing suspicion of peripheral vascular disease. History did not reveal any high-risk behavior. Clinical examination and subsequent investigations lead to the diagnosis of acute infective endocarditis of native aortic valve along with peripheral embolism caused by methicillin-resistant Staphylococcus aureus. Fogarty\'s balloon embolectomy was done following which patient developed pseudoaneurysm of the left subclavian artery. These iatrogenic sequelae were managed with the resection of the pseudoaneurysm and prolonged antibiotic therapy as per the culture and sensitivity report.

Ultrasound-guided thrombin injection has been well described as a safe and effective treatment for pseudoaneurysms of the femoral artery. However, cases for subclavian artery pseudoaneurysm are rare. An 82-year-old man developed an iatrogenic right subclavian artery pseudoaneurysm. The pseudoaneurysm, which was partially thrombosed, was successfully treated by ultrasound-guided percutaneous thrombin injection. A trial injection with saline under color Doppler ultrasonography was helpful for confirming that the tip of the needle was in the sac with blood flow in the partially thrombosed pseudoaneurysm. Ultrasound-guided thrombin injection can be the first treatment of choice to treat subclavian artery pseudoaneurysm.

Behçet\'s disease (BD) is a rare chronic systemic vasculitis of unknown etiology that presents in young adults. We report a very rare case of a left subclavian artery pseudoaneurysm identified after a left clavicle fracture in a 70-year-old man with a 40-year history of intestinal BD. The patient received fixation by banding to treat a fracture after falling from a bed about 5 months previously, and he was referred to our hospital due to the finding of a left subclavian pulsatile mass. As enhanced computed tomography showed a left subclavian artery pseudoaneurysm, it was repaired using an endovascular stent graft.

A rare case of a 56-year-old man with posttraumatic false aneurysm of the right subclavian artery is presented. He was admitted to hospital due to pain in the shoulder. The diagnosis was made upon ultrasonography and computed tomography (CT) results. With ultrasound guidance, the aneurysm was punctured and injected with bovine thrombin (Biotrombina 400u, Biomed). During the injection, the aneurysm neck was occluded by an endovascular balloon placed in the subclavian artery. Complete aneurysm embolisation was confirmed by ultrasound and CT studies. The postoperative course was complicated by Horner\'s syndrome which resolved completely within 3 weeks. The procedure technique is described in detail.
W pracy przedstawiono rzadki przypadek 56-letniego mężczyzny z pourazowym rzekomym tętniakiem prawej tętnicy podobojczykowej. Chory został przyjęty do szpitala z powodu bólu barku, a rozpoznanie ustalono na podstawie badania ultrasonograficznego (USG) i angiografii tomografii komputerowej. Wykonano embolizację tętniaka za pomocą trombiny bydlęcej podanej pod kontrolą USG. Podczas iniekcji szyję tętniaka zabezpieczono balonem wewnątrznaczyniowym rozprężonym w tętnicy podobojczykowej prawej. Skuteczność embolizacji potwierdzono badaniem angiografii tomografii komputerowej. Przebieg pooperacyjny był powikłany wystąpieniem zespołu Hornera, który ustąpił po 3 tygodniach. W pracy dokładnie przedstawiono technikę postępowania chirurgicznego.