Subclavian artery injury after clavicle fracture

Case contributed by Dalia Ibrahim

Presentation

History of clavicle fracture 2 years ago, now pain and claudications of the left upper limb.

Patient Data

Age: 35 years
Gender: Male

CT angiography showed a left subclavian artery 3 cm segment of irregular narrowing and multifocal stenosis with focal intimal dissection at the level of the mid-clavicular old non-united displaced fracture.

Patent left brachial, radial, ulnar, and inter-osseous arteries down to the wrist.

Case Discussion

Subclavian artery injury is a rare and life-threatening condition that might lead to arterial occlusion, and limb ischemia, retrograde thromboembolization, and cerebral infarction.

Subclavian artery injuries are common after clavicular fractures and usually caused by stretching, transection, or compression of the subclavian artery by broken bone fragments.

Other complications include pseudoaneurysm or arterial thrombosis with secondary limb ischemia.

Endovascular treatment is a very good option for the treatment of such injuries.

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