Subclavian artery aneurysm

• Causes
  • Trauma
    • Thoracic outlet syndrome
    • instrumentation
  • Connective tissue disorders
  • Iոfеction (ie, mycotic аոeurуѕm),
  • Fibromuscular dysplasia
  • Tumor
  • Vasculitis
• Clinical
  • Most subclavian artery aneurysms are asymptomatic, presenting as a pulsatile supraclavicular mass
  • Symptoms occur
    • Ischemic manifestations of distal embolization.
      • Macroemboli can cause acute or chronic upper extremity ischemia
      • Microemboli can cause digital symptoms including subungual splinter hemorrhages or digital pain, discoloration, or ulceration.
• Managemnt
  • Symptomatic
    • Repair
  • Asymptomatic
    • If intraluminal thrombus should be repaired
    • Small asymptomatic aneurysms without intraluminal thrombus may be managed conservatively and evaluated with serial imaging - no consensus on size however > x2 increase in size is used
  • Options
    • Open or endovascular