Pseudoaneurysm of the subclavian artery following clavicle fracture due to blunt traumatism: a case report

Abstract

The clavicle fractures are frequent, vascular
injuries associated with closed fractures of clavicle
are rare. The pseudoaneurysms of the subclavian
artery constitute an exceptional complication. We
report a case of a 40-year-old who presented an
expanding hematoma of the right side of the neck
after a road traffic accident. Radiography of the
right shoulder showed a midclavicular fracture. An
arterial doppler of vessels showed a circulating
hematoma in the contact of the right subclavian
artery with a correct distality flow. Computed
tomographic angiogram of the chest confirmed the
diagnosis of a false aneurysm in the postvertebral
portion of the right subclavian artery. The
treatment was surgical and consisted of excision of
the false aneurysm and a repair of the arterial
injury by an arterial patch, the clavicle was fixed
with a reconstruction plate and screws. Early
intervention appears to be indicated due to the risk
of thrombo-embolic complications. Endovascular
repair appears to be the preferred treatment
modalities, due to a lower rate of cardiopulmonary
complications, but it is reserved for much selected
cases.