Spontaneous Resolution Of Delayed Onset Large Subclavian Artery Pseudoaneurysm
Ohta, T., Maekawa, H., Kasuno, K., Tsukamoto, T., Muso, E., & Ishikawa, M. (2009). spontaneous resolution of delayed onset large subclavian artery pseudoaneurysm. Neurologia medico-chirurgica, 49(11), 517–519. https://doi.org/10.2176/nmc.49.517
View Original Source →Abstract
A 70-year-old woman with a history of end-stage renal disease secondary to anti-neutrophil cytoplasmic autoantibody-associated vasculitis had been receiving hemodialysis for 5 years. The patient underwent attempted right internal jugular vein cannulation for temporary hemodialysis catheter placement. Pulsating mass developed in the neck and angiography revealed a subclavian artery pseudoaneurysm 4 days later. The pseudoaneurysm disappeared spontaneously during the interval between the diagnosis and the planned surgical procedure. Such delayed onset and spontaneous resolution of subclavian artery pseudoaneurysm is uncommon. Close observation may be optimal if delayed onset of pseudoaneurysm occurs after small needle puncture with cessation of antiplatelet/anticoagulant administration.
Case Details
Disease Location
Right subclavian artery
Personal Characteristics
70 years old woman, history of end-stage renal disease secondary to anti-neutrophil cytoplasmic autoantibody-associated vasculitis. Hemodialysis for 5 years. The arteriovenous (av) shunt in her left forearm had become stenotic twice
Clinical Characteristics
She was admitted for a third revision of the av shunt. Left forearm became stenotic twice due arterio-venous shunt. Unsuccessful catheterization for hemodialysis. The right jugular vein was punctured during a catheterization attempt. Manual compression of the right side of her neck was performed for 40 minutes. 4 days later, a pulsating mass developed in the neck's right side. Angiography confirmed a pseudoaneurysm.
Remission Characteristics
The pseudoaneurysm disappeared spontaneously
Treatment & Mechanisms
Proposed Remission Mechanisms
Balloon angioplasty
Clinical Treatment
Aspirin and hemodialysis with nafamostat mesilate from day 1. Aspirin administration stopped on day 4. Coil embolization on day 11.