PMC6796688_01
CT Angiography Chest. A. Coronal view: visualized above is a left subclavian/axillary artery injury with contrast extravasation at the site of injury along the course of the artery coursing out of the neck and in to the left shoulder. B. Sagittal view: a large amount of extravasation is seen in the left shoulder area along with an expanding hematoma. Subcutaneous emphysema is also visualized.
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CT Angiography revealed injury to the left subclavian artery, an active area of extravasation with a large pool of contrast in the axillary artery and an expanding hematoma (Fig. 1, Fig. 2, Fig. 3).
CT Angiography Chest. A large, rapidly expanding hematoma creating an asymmetrical enlargement with slight deviation of the trachea to the right - away from the hematoma. Subcutaneous emphysema is noted in this image as well.
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CT Angiography revealed injury to the left subclavian artery, an active area of extravasation with a large pool of contrast in the axillary artery and an expanding hematoma (Fig. 1, Fig. 2, Fig. 3).
Diagnostic angiograms performed to better visualize injury. A. Extravasation of contrast material is seen close to the left clavicle on this angiogram view making this a difficult anatomical location for repair. B. Large amount of contrast extravasation indicating injury to the artery.
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Intraoperatively, selective angiograms better characterized the injury (Fig. 4) and the decision was made to use a covered stent.
Completion angiograms demonstrated successful endograft exclusion. A. Angiogram of the left axillo-subclavian artery injury post Viabahn stent placement. B. Vascular flow without extravasation of contrast material immediately following stent placement. C. Arterial flow within the left subclavian artery is seen coming off of the aorta. D. The proximal Viabahn stent is well visualized here into the proximal left subclavian artery. Blood flow into the left subclavian and left axillary arteries are intact without extravasation.
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Completion angiograms were performed to rule out an endoleak, and to confirm good distal runoff to the upper extremity (Fig. 5).