Hybrid procedures combining open and endovascular surgical techniques for the management of subclavian artery injuries.

Subclavian vascular injuries are notorious for their difficult surgical exposure. Proximal and distal control of the vessel may require a combination of supraclavicular or infraclavicular incision, clavicular transection, median sternotomy, or thoracotomy. Such an extensive dissection is associated with significant morbidity, whereas delay or loss of control can result in rapid exsanguination and death. In this context, endovascular maneuvers may offer an appealing alternative approach to these technically challenging injuries. We describe the management of two complex traumatic false aneurysms of the proximal subclavian artery using a combination of open and endovascular techniques.