Ahmed M. Almahrouky , Mohamed Rafik
Ahmed Faraghaly¹, Ahmed Elmarakby¹, Ahmed Gamal Eldin Fouad¹, Fatma Zeinhom² & Wesam El-Din Sultan³
Ahmad Gamal1, Haitham A. Eldmarany1, Ahmed Farghaly1, Ahmed Elmarakby1, Ayman Refaat2.
Ahmed Nawar1, Waleed Reda1, Ahmed Safwat1, Sahar Mansour2
Mohamed Saber MSc, Tarek Hegazy MD,MRCS
Hossam Elmahdy; Waleed Eldaly; Hussein Elwan; Baker Ghoneim
Ahmed H. Ali FRCS and Hany Rafik MD
Hany M S Mikhail MD, FRCS, Hany A. Balamoun MD, FRCS
Abd Elrahman Elmaraghy, Mahmoud Saad Farahat and Mohammed abdo MD
Mahmoud Saad1, Haitham Mostafa Elmaleh1and Safaa Refaat El-Sady2
Ahmed H. Ali,FRCS
1Amr Mohamed Salem, 2Mohamed Mohamed Mokhtar, 2Sahar Ahmed El Shafei, 3Omaima Gaber Yassine, 2Eman Farouk Safwat
Shehab Soliman , Ahmed F. Aborady
Mr. Ayman M. A. Osman1 MD, MRCS (Eng); Mr. Sameh A. Mikhail1 MD, FRCS (Eng), MRCS (Eng); Mr. Mohamed E. Alkashty1 M.Sc.; Prof. Mohamed H.A. Fahmy1 MD.
Sherif Essam Eldin Tawfik; Ahmed Farouk Abdelmohsen; Mohamed Abd El-Monem Abd El-salam Rizk
Marwan Yousry, Hossam El Mahdy, Walied Eldaly, Hussein Elwan
Wael Ghanem MD*, and Mohamed Eldebeiky MD, FRCS*, Ayman Albaghdady MD*
Wael Ghanem MD
Sameh Mikhail1, Shady Elghazaly Harb 1, Sherif M. Mokhtar 1, Mohamed ElNady 2
Amr Saleh El Bahaey and Haitham A.Eldmarany
Haitham A. Eldmarany1, Amr Saleh El Bahaey2
Feasibility, Short and Mid-term Outcomes of Endovascular Management of Subclavian Artery Aneurysms
Introduction: Recently, with the paradigm shift in vascular aneurysm repair, stent graft treatment has
emerged as a less invasive option for management of subclavian artery aneurysms with lower rate of
morbidity and mortality whenever acceptable proximal and distal landing zones available to help graft
fixation. Method: Endovascular exclusion by covered stent was offered to all allegeable patients with
Subclavian artery aneurysm presented to the vascular surgery department, Kasr Al-Aini hospital, Cairo
University between March 2012 and April 2015. Our exclusion criteria included: active uncontrollable
hemorrhage, critical upper limb ischemia and infected trauma wounds as well as excessive luminal
discrepancy between the proximal and the distal arterial segments. Unilateral or bilateral femoral access
was utilized and additional brachial access to aid stent graft crossability through supporting the wire was
employed occasionally. Planned post-operative evaluation included clinical and duplex arterial evaluation
after 1, 3 and 6 months respectively. Results: 15 patients with subclavian artery aneurysm were enrolled.
Their age range was 14 - 47 years (mean, 32.1). All 15 patients (12 male; 3 female) had undergone stent
graft exclusion. False aneurysms were encountered in 11 patients while true aneurysms were found in 4
patients. All stent grafts were placed via femoral approach except for one patient for whom the graft was
placed through a trans brachial approach. A variety of stent graft diameters (7-9 mm) and lengths (60 -
100 mm) were used. The stent grafts used included 11 Wallgraft (Boston Scientific), 4 Fluency (Bard), and
one Advanta V12 (Atrium medical). One patient required second stent grafts to repair type I endoleak
caused by incorrect positioning and slipping of the first stent grafts. No conversion to open repair was
necessary and no periprocedural blood transfusions were required. All stent graft devices were successfully
deployed with total exclusion of the aneurysms. There was one procedure-related complication (6.6%),
consisting of groin pseudoaneurysms requiring surgical repair 7 days after the procedure. Conclusion:
Endovascular stent-graft placement is a promising and less invasive alternative to surgery and potentially
carries a lower morbidity and mortality rate and result in shorter operative time and less blood loss.
Key words: Aneurysms, Subclavian, Endovascular.