Systematic Review and Reconstructed Individual Patient Data of Atherosclerotic Subclavian Artery Aneurysm in the Endovascular Era.

BACKGROUND

To summarize incidence, presentation, management, and outcomes of true isolated atherosclerotic subclavian artery aneurysms (SAAs) in the endovascular era using reconstructed individual patient data.

METHODS

Medline and Embase were searched (1993-2025). Primary outcome was 30-day complications; secondary outcomes included follow-up (FU) events and aneurysm characteristics.

RESULTS

Sixty-seven SAAs in 66 patients were included. Symptoms occurred in 56%, mainly compression, hemoptysis, or embolization; rupture occurred in 22%. Open, endovascular, and hybrid repair were performed in 34%, 46%, and 20%, respectively. Thirty-day complications occurred in 9%, without differences among strategies. During 12-month median FU, late complications were comparable. Aneurysm diameter, side, and location were not associated with symptoms.

CONCLUSION

Atherosclerotic SAAs are rare and frequently symptomatic. Repair should not rely on diameter alone. Open, endovascular, and hybrid approaches are safe.