Endovascular Treatment of a Gunshot Injury of the Subclavian Artery

Objectives: We present a case of a patient with a right subclavian artery injury due to a gunshot, treated by endovascular approach in our clinic in Kielce, Poland. Case report: A 35-year-old male, presented with a penetrating injury of the right supraclavicular region due to a shotgun slug. The patient was hemodynamically unstable. Both chest radiograph and CTA (Computed Tomography Angiography) imaging presented an injury of the right subclavian artery, multisegmental rib fractures of ribs I-III and a hemo-pneumothorax. Endovascular repair of the subclavian artery was performed, followed by insertion of a Redon wound drain and right-sided pleural drain. The patient was then transported to the thoracic surgery unit, where further therapy, including a removal of the bullet from the thoracic wall, was performed. Upon a 4 months follow-up visit, the patient was in a good condition and a CTA scan performed at this time confirmed the patency of the right subclavian artery. Conclusions: Endovascular repair presents a viable alternative option for treating subclavian artery injuries, even in hemodynamically unstable patients.