Subclavian artery injuries are sporadic, and the most common aetiology is trauma. Self-injury of the vessel in those misusing intravenous drugs is a rare complication, as most reports describe injury to the femoral artery. Thus, erosion and potential rupture of the arterial wall is possible due infection and phlegmon or abscess formation. We present a case of a young, female, hemodynamically unstable intravenous drug user admitted to the emergency department with a life-threatening, purulent haemorrhagic mass located at her right lateral cervical region. The patient admitted an inadvertent arterial puncture 10 days prior and an effort to self-manage the bleeding with the application of self-pressure and antibiotics. Computed tomography arteriogram of the neck revealed a gigantic, multicompartment, thick-walled collection with hyperdense fluid in her right supraclavicular region while active extravasation derived from the right subclavian artery was evident in late arterial phase. The patient was treated with endovascular graft stenting, despite the given presence of infection, as a salvage operation due to time limitation in open surgical repair.

Subclavian artery injuries are sporadic, and the most common aetiology is trauma. Self-injury of the vessel in those misusing intravenous drugs is a rare complication, as most reports describe injury to the femoral artery. Thus, erosion and potential rupture of the arterial wall is possible due infection and phlegmon or abscess formation. We present a case of a young, female, hemodynamically unstable intravenous drug user admitted to the emergency department with a life-threatening, purulent haemorrhagic mass located at her right lateral cervical region. The patient admitted an inadvertent arterial puncture 10 days prior and an effort to self-manage the bleeding with the application of self-pressure and antibiotics. Computed tomography arteriogram of the neck revealed a gigantic, multicompartment, thick-walled collection with hyperdense fluid in her right supraclavicular region while active extravasation derived from the right subclavian artery was evident in late arterial phase. The patient was treated with endovascular graft stenting, despite the given presence of infection, as a salvage operation due to time limitation in open surgical repair.

UNASSIGNED: Despite the increasing number of liver and kidney transplants, the number of patients awaiting for a proper donor is still exceeding. Therefore, the preservation of donor organs is critically advocated.
METHODS: Herein, we presented a successful liver and kidney transplant from a brain-dead donor who was found preoperatively to have simultaneous aortic dissection and intramural hematoma and additionally developed left subclavian artery dissection and perforation, which was noticed following sternotomy.
UNASSIGNED: This case experience highlights the key role of cardiac surgeons in preserving visceral organs by rapid repair of the dissection and perforation sites of the aorta and its branches which culminate in lifesaving organ donation.
CONCLUSIONS: This case report introduces the first case of a successful; liver and kidneys transplant in a patient with concurrent aortic dissection and subclavian artery rupture which served as a lifesaving donor.

An 89-year-old woman underwent transcatheter aortic valve implantation (TAVI) for severe aortic valve stenosis, based on a logistic European System for Cardiac Operative Risk Evaluation of 59.6% and Society of Thoracic Surgeons risk score of 17.1%. The patient had multiple comorbidities including chronic kidney disease with creatinine clearance of 15 ml/min. We ruled out preprocedural contrast-enhanced computed tomography and coronary angiography to prevent exacerbation of renal dysfunction. Moreover, we concluded that a trans-subclavian approach was optimal, because the transfemoral approach was contraindicated due to severe lordosis, and the transapical approach was contraindicated due to severe chronic obstructive pulmonary disease and frailty. This report describes a massive pleural effusion that led to the discovery of subclavian artery rupture causing hemodynamic shock. Hemodynamic instability in this patient was caused by hypovolemic and obstructive shock, with a pleural perfusion caused by subclavian artery rupture. Monitoring via transesophageal echocardiography during the procedure enabled early discovery of the massive pleural effusion. Subsequent covered stent implantation stabilized the subclavian artery rupture, and the patient became hemodynamically stable. As subclavian artery rupture can occur during trans-subclavian TAVI, the presence of calcifications and tortuosity requires careful management. .