Combined supra-aortic extra-anatomic revascularization and endovascular hybrid procedure for recurrent hemoptysis caused by a symptomatic aneurysm of the right subclavian artery

Subclavian aneurysm presenting with massive hemoptysis: a case report and review of the literature

We present a case of a 70-year-old male with a past medical history of coronary artery bypass grafting and end stage renal disease who presented with massive hemoptysis. He had a history of methicillin-resistant Staphylococcus aureus endocarditis, with infection and removal of endocardial pacing leads. His work-up revealed a 2.9-cm proximal left subclavian artery aneurysm. Bronchoscopy confirmed bright red blood in the left upper lobe bronchus and coronary angiography confirmed a patent left internal mammary artery (LIMA) to left anterior descending bypass. Because of the consideration of maintaining coronary perfusion via the LIMA while excluding the subclavian aneurysm, he underwent a left carotid to left axillary artery bypass graft followed by deployment of an Amplatzer II vascular plug just distal to the aneurysm. A thoracic endograft was then deployed to exclude the origin of the subclavian. A review of the literature reveals hemoptysis as a rare presentation of a subclavian aneurysm. We discuss approaches to this challenging clinical problem, ranging from open repair to hybrid approaches.

Hemoptysis caused by a left subclavian pseudoaneurysm: endovascular solution for a challenging case

This is one of the first reports of a left subclavian pseudoaneurysm in a patient presenting with massive hemoptysis. We present a challenging case of a patient who consulted for hemoptysis. Imaging revealed a left subclavian artery pseudoaneurysm that caused a pulmonary parenchymal lesion. Treatment with a self-expanding thoracic stent-graft and a subclavian occluder was successful.