외상 후 상지통증과 반복적인 원위부로의 색전증이 동반된 쇄골하 위동맥류 증례 보고

Abstract

A pseudoaneurysm of the subclavian artery is an uncommon complication of a blunt or penetrating trauma to the shoulder. As with aneurysms in other locations, it may result in rupture, thrombosis or embolization. Because these vascular injuries are missed initially, considerable morbidity can ensue from complications. Early diagnosis followed by resection or exclusion is advocated. Herein is report a rare case of a traumatic pseudoaneurysm of the left subclavian artery, with repetitive distal embolization events, in a 59-year-old woman. She was admitted with pain in the left forearm of 3 months duration. Her history revealed a blunt trauma to the left shoulder 3 years previously, with pain in the left shoulder ever since. Although the initial angiography showed a left subclavian aneurysm with brachial arterial embolization, a diagnosis of brachial artery occlusion was initially made. After repetitive events of distal embolization, the last angiography confirmed a subclavian pseudoaneurysm, presumably resulting from the blunt trauma to the shoulder 3 years earlier. The pseudoaneurysm, containing a thrombus, was thought to be the source of the artery-to-artery embolization.