Surgical repair of traumatic right subclavian artery pseudoaneurysm after war shrapnel injury: A case report.

A rare right subclavian artery pseudoaneurysm developed after a war-related shrapnel injury in a 46-year-old female with a prior thyroidectomy. There was no initial bleeding or neurologic deficit, and initial noncontrast computed tomography findings were negative. One month later, the patient presented with chest pain, hoarseness, and dysphagia. A chest X-ray showed tracheal compression, Doppler ultrasound revealed leakage from the posterior wall of the right subclavian artery, and computed tomography angiography confirmed a 6 × 7 cm pseudoaneurysm causing 70% tracheal narrowing. Open repair was performed via partial sternotomy and a subclavicular incision using a 7-mm Dacron graft. The hospital stay was 3 days (1 day in the intensive care unit), without complications. Follow-up Doppler at 1 and 3 months showed graft patency, normal palmar arch waveforms, and symptom resolution.