# Coil embolization of a giant pseudoaneurysm associated with a disrupted axillary artery: a case report

## TL;DR

A 54-year-old woman with a disrupted axillary artery was successfully treated with coil embolization for a giant pseudoaneurysm, preserving blood flow to her arm.

## Contribution

This case report presents a rare use of coil embolization for a disrupted axillary artery pseudoaneurysm with preserved collaterals.

## Key findings

- Coil embolization preserved collateral blood flow to the brachial artery.
- The patient regained arm and hand warmth within four days post-treatment.
- Post-embolization imaging confirmed preserved radial artery blood flow.

## Abstract

Stent-graft placement is generally used to treat pseudoaneurysm (PSA) of the axillary artery (AA) trunk to maintain the patency of peripheral vessels. Coil embolization of a PSA associated with a disrupted AA trunk has rarely been reported.

A 54-year-old woman presented with swelling of her right shoulder. She had had a right proximal humeral fracture 12 years earlier. Contrast-enhanced computed tomography (CECT) and subsequent angiograms revealed a giant PSA at the disrupted, distal right AA. There were collateral flows to the brachial artery from the proximal to the right AA. To preserve collateral flows to the brachial artery, selective embolization of the inflow artery that derived from the distal AA was performed with hydrogel-coated coils. The post-embolization arteriogram showed no flow into the PSA, but collateral flows to the brachial artery we preserved. The post-embolization course was uneventful. The patient regained warmth in her right arm and hand on post-embolization day 4. Repeat CECT on post-embolization day 9 confirmed blood-flow to her right radial artery.

While a stent-graft should be used if the AA trunk can be preserved, coil embolization should be considered for PSA if the AA trunk is disrupted but collaterals are preserved.