Collateral artery aneurysm: a unique presentation of thoracic outlet syndrome

Suprascapular Artery Aneurysm Secondary to Severe Shoulder Joint Osteoarthritis

Aneurysms of the thyrocervical trunk and collateral branches are rarely encountered. Upon literature review, no documented cases of a suprascapular artery aneurysm resulting from osteoarthritis have been previously described. A 64-year-old female was found to have focal aneurysmal formation within the suprascapular artery. The extensive osteoarthritic changes to the glenoid, including medialization of her joint line, is hypothesized to have led to arterial injury and the observed aneurysm formation. Chronic mechanical stress on small vessels from abnormal bony contact in the setting of osteoarthritis can lead to aneurysmal formation. Arthritis as a cause of aneurysm formation in collateral vessels of the thyrocervical trunk has not been previously described.

True Aneurysm of the Left Internal Thoracic Artery

Aneurysms of the internal thoracic artery (ITA) are rare and can have many etiologies. Hyperflow is an exceptional etiology. We report the case of a 56-year-old woman who presented with a stress-induced ischemia of the left arm. Computed tomography angiography showed occlusion of the subclavian artery and a true aneurysm of the ITA. The ITA aneurysm was resected without restoration of the ITA continuity and a carotid-subclavian bypass was performed. Pathological examination of the aneurysm sac was not specific.

Ruptured subscapular artery aneurysm and subclavian artery occlusion in a patient with type 1 neurofibromatosis: a case report

Introduction

Collateral muscular artery aneurysm is exceedingly rare. We report the first case of subscapular artery aneurysm in a patient with type 1 neurofibromatosis and ipsilateral chronic subclavian artery occlusion.

Case presentation

A 74-year-old Caucasian woman with a medical history of type 1 neurofibromatosis, presented a sudden left pectoral mass, later diagnosed as a ruptured aneurysm of the left subscapular artery. It was caused by a chronic occlusion of the left subclavian artery, diagnosed on angiographies prior to embolization.

Conclusions

Collateral artery aneurysm in the event of a mainstream muscular artery chronic occlusion may occur in type 1 neurofibromatosis.

Successful embolization of a suprascapular artery aneurysm

A 45-year-old woman was referred to our service because 9 months earlier she had developed a pulsating mass on the right supraclavicular fossa and torticollis. Ultrasounds and computed tomographic arteriography showed the presence of a subclavian collateral artery aneurysm with a diameter of 21 mm. On selective arteriography, an aneurysm of a suprascapular artery arising directly from the right subclavian artery was reported. The presence of thoracic outlet syndrome was excluded. The aneurysm was successfully treated with ethylene-vinyl alcohol polymer, a liquid embolic agent. The patient was discharged on postoperative day 1 in good general condition. After 12 months, control ultrasounds confirmed the complete thrombosis of the aneurysm sac.

Anomalous origin and aneurysm of the suprascapular artery: the first case observed

A 45-year-old woman was referred to our department having suddenly developed, 9 months earlier, a pulsating mass on the right supraclavicular fossa and torticollis. Colour Doppler sonography and computed tomographic angiography showed the presence of an aneurysm (21 mm in diameter) of the suprascapular artery that had an anomalous origin from the subclavian artery. Thoracic outlet syndrome was excluded. After selective arteriography, the aneurysm of the suprascapular artery was successfully treated with ethylene-vinyl alcohol polymer (Onyx, MicroTherapeutics, Irvine, California, USA), a liquid embolic agent. The patient was discharged on the first postoperative day in good condition. Control colour Doppler sonography at 1 year confirmed the complete thrombosis of the aneurysm sac.