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Kao et al. Vessel Plus 2018;2:18 Vessel Plus
DOI: 10.20517/2574-1209.2018.42

Case Report Open Access

Iatragenic injury to axillary artery: rescued by
endovascular repair

Chih-Chen Kao, Yao-Kuang Huang
Division of Thoracic and Cardiovascular Surgery, Chiayi Chang Gung Memorial Hospital, Chiayi 613, Taiwan.

Correspondence to: Dr. Yao-Kuang Huang, Division of Thoracic and Cardiovascular Surgery, Chiayi Chang Gung Memorial
Hospital, Chiayi 613, Taiwan. E-mail: cckaomd@gmail.com

How to cite this article: Kao CC, Huang YK. Iatragenic injury to axillary artery: rescued by endovascular repair. Vessel Plus
2018;2:18. http://dx.doi.org/10.20517/2574-1209.2018.42

Received: 4 Jun 2018 First Decision: 25 Jun 2018 Revised: 28 Jul 2018 Accepted: 30 Jul 2018 Published: 10 Aug 2018
Science Editor: Mario F. L. Gaudino Copy Editor: Jun-Yao Li Production Editor: Huan-Liang Wu

Abstract
Most of axillo-subclavian artery injuries are due to violence. Iatrogenic injuries to such vessels are relatively rare. We
hereby present the first report of pigtail catheter insertion for right upper chest wall hematoma drainage resulting in
penetration of axillary artery and pseudoaneurysm formation. A 39-year-old male victim of motor vehicle accident
developed right upper chest wall hematoma after initial conservative treatment. Subsequent admission was arranged
and pigtail catheter drainage was performed under sonography guidance. The procedure caused penetrating injury to
his right axillary artery with pseudoaneurysm formation. Endovascular repair and stent placement were performed. The
patient was discharged within 2 weeks without significant sequelae. Non-catheterization procedure caused penetration
of axillary artery was rarely seen in published reports. Our report described a case of axillary artery penetration resulted
by pigtail catheter insertion which was never seen. We wish to emphasize on the jeopardy of non-vascular procedure on
penetrating nearby vessels because of anatomical proximity.

Keywords: Trauma, vascular injury, endovascular surgery

INTRODUCTION
Thoracic cage and shoulder girdle provide a well protection of the proximate major vessels. Therefore, inju-
[1]
ries to such vessels which are adjacent to thoracic inlet, including axillo-subclavian artery are fairly rare .
On the other hand, the well protection of these vessels by local anatomy also posed a challenge for surgeons
to approach them during open surgery. The rareness of such cases further increases the risk of open opera-
tion of axillo-subclavian vessel repair due to inexperience of even senior cardiovascular surgeons. Stab and
[2]
gunshots are among the majority of mechanism causing injuries to axillo-subclavian artery . Iatrogenic in-
[3]
juries are relatively minor in proportion . Overall mortality of patients with axillo-subclavian artery injury
© The Author(s) 2018. Open Access This article is licensed under a Creative Commons Attribution 4.0
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