European Journal of Molecular & Clinical Medicine

A female in her early thirties, non-smoker, with no known comorbidities, presented to the emergency room with multiple episodes of hemoptysis and exertional dyspnea for a week. She had no history of hemoptysis or any known lung disease in the past. Chest X-Ray revealed relatively small right lung with mediastinal shift to the right. CT angiography revealed right-sided absence of pulmonary artery with collateral supply (systemic to pulmonary shunt) from hypertrophied bronchial, internal mammary and intercostal arteries. She was successfully managed with therapeutic selective embolization of bronchial arteries to control the hemoptysis.

Background:Subclavian artery vascular lesions are rare and can present with
catastrophic complications. Pseudo aneurysms can develop in subclavian artery and
represent less than 5% of all vascular lesions. They are usually seen secondary to
trauma or iatrogenic procedures. We present a rare case of pseudo aneurysm arising
from branch of subclavian artery with imaging findings and followed by intervention. A
47 year old female came with complaints of swelling in the right supraclavicular region
for 3 months which was gradual in onset and associated with mild pain there is no
history of significant trauma or recent invasive procedures and No significant surgical
history, No co-morbidities present.Ultrasound of the neck done elsewhere showed a
well-defined heterogenous vascular lesion in the right supraclavicular region showing
arterial wave form on colour Doppler and CT angiography was suggested for further
evaluation and patient referred to radiology department. Management options include
both surgical and less invasive procedures. Surgical procedure remains a challenge and
generally requires either a sternotomy or supraclavicular / infraclavicular approach
and Risk of significant blood loss and injuries to adjacent neurovascular structures can
occur. Various methods of endovascular treatment includes coil placement, covered
stents, injection of Polyvinyl alcohol particles, gel foam and endoluminal thrombin
injection. Pseudoaneurysm is a important vascular abnormality to be recognised by
imaging and Potential complications carry high morbidity and mortality rates. Early
diagnosis and intervention can prevent potential complications and Endovascular
management offers a safe and effective option with faster recovery.