Surgical Treatment of the Right Subclavian Artery Aneurysm

DOI
  • Nakazawa Junji
    Department of Thoracic and Cardiovascular Surgery, Sapporo Medical University
  • Kawaharada Nobuyoshi
    Department of Thoracic and Cardiovascular Surgery, Sapporo Medical University
  • Ito Toshiro
    Department of Thoracic and Cardiovascular Surgery, Sapporo Medical University
  • Maeda Toshiyuki
    Department of Thoracic and Cardiovascular Surgery, Sapporo Medical University
  • Kurimoto Yoshihiko
    Department of Traumatology and Critical Care Medicine, Sapporo Medical University
  • Higami Tetsuya
    Department of Thoracic and Cardiovascular Surgery, Sapporo Medical University

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Other Title
  • 鎖骨上アプローチで手術可能であった右鎖骨下動脈瘤の1例

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Abstract

A 48-year-old woman underwent breast-conserving surgery with sentinel lymph node dissection for a right breast cancer one year ago. During the follow-up observation, computed tomography (CT) revealed an aneurysm of the right subclavian artery; hence, she was referred to our department. The previous surgery left no trace of a central venous catheter. The CT showed a 20×17 mm extrathoracic aneurysm of the right subclavian artery located closer to the cranium than the clavicle. The surgery was carried out via a supraclavicular approach in a supine position under general anesthesia. A 5-cm skin incision was made on the right supraclavicular fossa. After the sternocleidomastoid muscle, internal jugular vein, and phrenic nerve were retracted, and the subclavian artery and aneurysm were identified. After heparin administration, the proximal and distal sides of the aneurysm were clamped and then resection was performed. The subclavian artery was reconstructed by end-to-end anastomosis without a prosthetic graft because the artery was well preserved. The postoperative course was uneventful with no complication. This experience presents the feasibility of supraclavicular approach for surgical management of extrathoracic aneurysm of the subclavian artery. Thus, we report this case with a review of the literature.

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