Subclavian Artery Aneurysm in a HIV Infected Patient - Case Report

Aim: To highlight the presentation and endovascular management of a leaking subclavian artery aneurysm in a patient with human immunodeficiency virus infection.

Background: The presentation of human immunodeficiency virus infection and its complications continue to be an ever-evolving diagnostic challenge for physicians all over the globe. Patients in the younger age group with de novo peripheral arterial aneurysms occasionally present with alarming complications. Subclavian artery aneurysm is one such entity which can be treated successfully with endovascular techniques.

Case Description: 45 yr. old diabetic female patient initially treated for upper respiratory tract infection later presented with a swelling in the right lower neck region. The cervical lymph node biopsy and blood tests confirmed positive for human immunodeficiency virus. She had spontaneous bleeding from the neck region and an urgent angiography revealed a leaking aneurysm at the origin of the right subclavian artery. This was treated with endovascular technique by using a covered stent and also sealing the retrograde flow from the vertebral artery.

Conclusion: In the setting of bleeding in young patients with peripheral arterial non-traumatic aneurysms, endovascular management is the most efficient modality of treatment. The use of covered stents and percutaneous approach ensures a rapid recovery and avoids post-operative wound related complications.

Clinical Significance: The aforementioned case will allow an improved clinical acumen and permit the early diagnosis of arterial aneurysms in the head and neck region. The highlighted endovascular treatment option may be used as a first line approach for treatment with the availability of required equipment and local expertise.