Blunt subclavian artery injury treated with a peripheral vascular stent graft for hemorrhagic shock using a hybrid emergency room system

Abstract

We report the case of a 68-year-old man who experienced hemorrhagic shock due to a blunt-force left subclavian artery injury sustained during a fall accident. The patient was treated using our Hybrid Emergency Room System (HERS), which integrates the emergency room, CT, interventional radiology (IVR), and operating rooms, enabling seamless diagnostics and treatment. Contrast-enhanced CT revealed a left subclavian artery injury, left clavicle fracture, and extravasation. Hemostasis was achieved with a peripheral stent graft successfully placed using our HERS without complications. Subclavian artery injuries are rare and associated with high mortality rates. While surgical intervention is standard, endovascular treatments are increasingly preferred owing to the challenges and associated risks posed by surgical exposure. This case demonstrates the efficacy of prompt CT-guided endovascular treatment for injury characterization and resuscitation. Our approach underscores the advantages of the HERS in safe and effective management of complex trauma cases.