• Journal of Chest Surgery
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• v.25 no.11
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• pp.1278-1281
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• 1992

We have experienced two cases of traumatic subclavian artery rupture at the department of thoracic and cardiovascular surgery, Youngdong Severance hospital, Yonsei University college of medicine. One was combined with brachial plexus injury and the other was combined with brachial plexus injury and subclavian vein rupture. They were treated with graft interposition after segmental resection of ruptured subclavian artery and neurorrhaphy for brachial plexus injury. Post operative courses were not eventful.

• Journal of Chest Surgery
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• v.28 no.9
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• pp.881-884
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• 1995

Improvements in the operative management of traumatic aortic transection have resulted in safe and expeditious repair. Nonetheless, multisystem injuries continue to inflict significant numbers of deaths. We have experienced a case of acute traumatic aortic transection in 41 years old male patient by a traffic accident. The transection was just distal to the origin of the left subclavian artery. We have done a synthetic graft interposition under left atrium to left femoral artery bypass with centrifugal pump. His postoperative course was smooth, and discharged without any complications.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.16 no.7
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• pp.4651-4655
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• 2015

The subclavian artery pseudoaneurysm in blunt trauma is uncommon and rarely occurs secondary to penetrating injury. Subclavian artery injuries represent an uncommon complication of blunt chest trauma, this structure being protected by subclavius muscle, the clavicle, the first rib, and the deep cervical fascia as well as the costo-coracoid ligament, a clavi-coraco-axillary fascia portion. Subclavian artery injury appears early after trauma, and arterial rupture may cause life-threatening hemorrhages, pseudoaneurysm formation and compression of brachial plexus. Most injuries were related to clavicle fracture, gunshot, other penetrating trauma, and complication of central line insertion. The presence of large hematomas and pulsatile palpable mass in supraclavicular region should raise the suspicion of serious vascular injury and these clinical evidences must be carefully worked out by physical examination of the upper limb. Since the first reports of endovascular treatment for traumatic vascular injuries in the 1993, an increasing number of vascular lesions have been treated this way. We report a case of subclavian artery pseudoaneurysm 10 days after blunt chest trauma due to traffic accident, treated by endovascular stent grafting.

• Journal of Chest Surgery
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• v.20 no.3
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• pp.588-592
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• 1987

A successful repair of traumatic descending thoracic aorta rupture was performed in a 27 year old man. The patient had automobile accident and transferred to our hospital. On admission, a chest film showed mediastinal widening and soon aortography was done. There was a fusiform aneurysm on the descending thoracic aorta just distal to the origin of the left subclavian artery measuring 5cm in diameter and 7cm in length. He underwent thoracotomy and the injured part of the aorta was replaced with a 24mm tightly Woven Dacron graft using femora-femoral bypass. The postoperative course was uneventful.

• Journal of Chest Surgery
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• v.22 no.5
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• pp.816-822
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• 1989

Aneurysms of the descending thoracic aorta can be caused by various etiologies. So, its abrupt rupture leads life-threatening state, it must be operated as soon as possible. Surgical treatment of the descending thoracic aortic aneurysm requires temporary cross-clamping of major artery. The obligatory occlusion of the descending thoracic aorta during management causes proximal arterial hypertension and distal arterial hypotension. The former may leads to left ventricular failure, or cerebrovascular accident, whereas the latter may leads to spinal cord ischemia or renal injury. Some have recommended insertion of temporary shunt around the occluded descending aorta to prevent above problems. Still others would favor expeditious operation employing simple aortic occlusion during the repair of the descending aorta. Recently we had experienced two cases of dissecting aneurysms of descending thoracic aorta which performed aortoplasty with Gore-Tex conduit under simple aortic occlusion. The one was 34-year-old female patient with traumatic dissecting aortic aneurysm [5 em X 5 cm] on the descending thoracic aorta distal to the origin of the left subclavian artery and the other was 58-year-old female patient with atherosclerotic dissecting descending thoracic aortic aneurysm [6 cmX7 cm] and diffuse abdominal aortic aneurysms [3X5 cm]. Both patients performed standard left posterolateral thoracotomy. After the aneurysmal sac was mobilized, occluding vascular clamps were placed on the transverse aorta proximal to the origin of the left subclavian artery, and on the distal descending aorta without adjuvant bypass procedures for 31 and 32 minutes, respectively, and the aneurysmal sac was repaired with 18 mm ringed Gore-Tex conduit graft. Both patients postoperative courses were uneventful.