Traumatic Subclavian Artery Pseudoaneurysm: Periprocedural Salvage of Failed Stent-Graft Exclusion Using Coil Embolization

Purpose: To report the exclusion of a subclavian pseudoaneurysm by a combination of covered stent implantation and coil embolization. Case Report: A 30-year-old man presented with a posttraumatic pseudoaneurysm of the left subclavian artery. A covered Jostent was inserted via a percutaneous femoral approach and deployed in the injured subclavian artery. Because of tapering of the artery proximally, apposition of the covered stent to the arterial wall was insufficient, leading to persistent filling of the pseudoaneurysm. Exclusion of the pseudoaneurysm was achieved by coil embolization through a gap between the stent-graft and the arterial wall. Conclusions: This report illustrates that successful endovascular treatment of a left subclavian pseudoaneurysm may require a combination of catheter-based techniques.