Successful management with endovascular stent graft repair following gunshot wound to the subclavian artery: Case report and literature review

INTRODUCTION: Penetrating injuries to the subclavian artery are usually the result of gunshot wounds or stab wounds. While subclavian artery injuries are relatively uncommon, vascular injuries due to penetrating trauma are frequently encountered at Trauma Centers. Despite advances in modern medicine, these injuries are associated with a high mortality and can lead to devastating morbidity. PRESENTATION OF CASE: We report a case of a 20-year-old male who presented after sustaining multiple gunshot wounds to his left upper and lower extremities. He underwent an emergent repair of a left axillo-subclavian artery injury via an endovascular approach using a covered self-expanding stent and was discharged after less than a week. DISCUSSION: Historically, open surgical repair was considered the gold standard in the management of subclavian artery injury. However, rapid technological developments and advances in vascular surgery offer alternative management approaches in traumatic vascular surgery. In a select subset of trauma patients with penetrating vascular injuries, a minimally invasive endovascular approach may be an option. Endovascular repairs are associated with shorter operative times, less blood loss, lower complications and also a reduced mortality rate. CONCLUSION: Endovascular stent graft prostheses offer a minimally invasive treatment modality in the management of traumatic penetrating subclavian artery injuries.