Delayed Presentation of Subclavian Artery Pseudoaneurysm Following Blunt Thoracic Trauma: A Case Report

TL;DR

A rare case of a subclavian artery pseudoaneurysm, appearing weeks after a motorcycle accident, highlights the importance of early diagnosis and the role of ultrasound in detection.

Contribution

This case report adds to the limited literature on delayed subclavian artery pseudoaneurysms following blunt trauma and emphasizes the diagnostic value of point-of-care ultrasound.

Findings

Subclavian artery pseudoaneurysm was diagnosed five weeks after initial trauma using point-of-care ultrasound.

The patient experienced persistent neurological deficits despite endovascular stenting.

The case highlights the need for high clinical suspicion in diagnosing delayed pseudoaneurysms.

Abstract

Subclavian artery pseudoaneurysms are a rare complication of blunt thoracic trauma with high mortality and incidence of long-term disability.

We describe a 49-year-old female who suffered a midshaft clavicle fracture after a motorcycle collision who presented five weeks later with right arm weakness, paresthesias, and persistent clavicle pain and swelling. She was diagnosed with a subclavian artery pseudoaneurysm on point-of-care ultrasound performed in the emergency department, which was confirmed with computed tomography angiography. She underwent endovascular stenting but continued to suffer from long-term neurologic deficits related to her condition.

This case underscores that the diagnosis of subclavian artery pseudoaneurysm requires a high index of suspicion. In addition, the case also highlights the utility of point-of-care ultrasound as a modality that can assist in arriving at the diagnosis.

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