Stent-graft placement for an axillosubclavian artery injury in a pediatric patient: A case report

Abstract

Axillosubclavian artery injury is a rare traumatic vascular injury associated with a high mortality rate. Therefore, rapid diagnosis and appropriate treatment selection are critical for patient survival. Although endovascular stent-graft placement has emerged as a less invasive alternative to open surgery, its application in pediatric trauma patients remains poorly documented. In this report, we present the case of a pediatric patient with traumatic axillosubclavian artery injury successfully treated with stent-graft placement. A 13-year-old boy was transported to a referring hospital following a traffic accident and transferred to our emergency and critical care center. Contrast-enhanced computed tomography conducted on hospital day 2 revealed a pseudoaneurysm due to right axillosubclavian artery injury, prompting endovascular stent-graft placement. The patient was discharged on hospital day 23. Although contrast-enhanced computed tomography at 1-year after discharge confirmed severe stenosis within the stent graft, distal perfusion was maintained. Notably, no ischemic symptoms or growth disturbances were observed in the right upper limb at the 3-year follow-up. Endovascular stent-graft placement appears to be a viable treatment for axillosubclavian artery injury in selected pediatric patients, particularly adolescents.