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Int J Angiol. 2013 Mar;22(1):69-74. doi: 10.1055/s-0033-1333862.

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

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Department of Vascular Surgery, Yale University School of Medicine, New Haven, Connecticut.
Department of Interventional Radiology, Yale University School of Medicine, New Haven, Connecticut.
Department of Cardiothoracic Surgery, Yale University School of Medicine, New Haven, Connecticut.


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.


aneurysm; endovascular repair; hemoptysis; hybrid; subclavian

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