Subclavian artery rupture during transluminal angioplasty: Treatment by transcatheter occlusion and surgical bypass

Percutaneous transluminal angioplasty of a proximal left subclavian artery stenosis was complicated by arterial rupture at the angioplasty site with formation of a pseudoaneurysm. The subclavian artery was subsequently intentionally occluded across the site of the pseudoaneurysm with coil springs to prevent free rupture and potentially severe haemorrhage. This was immediately followed by surgical placement of an axillo-axillary bypass graft to revascularise the left upper extremity. Thus a direct intra-thoracic operative repair of the subclavian artery was avoided.