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Oka N, Kuriyama A, Ishisaka Y. Coil embolization of a giant pseudoaneurysm associated with a disrupted axillary artery: a case report. CVIR Endovasc 2024; 7:28. [PMID: 38466506 DOI: 10.1186/s42155-023-00408-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 11/21/2023] [Indexed: 03/13/2024] Open
Abstract
BACKGROUND Stent-graft placement is generally used to treat pseudoaneurysm (PSA) of the axillary artery (AA) trunk to maintain the patency of peripheral vessels. Coil embolization of a PSA associated with a disrupted AA trunk has rarely been reported. CASE PRESENTATION A 54-year-old woman presented with swelling of her right shoulder. She had had a right proximal humeral fracture 12 years earlier. Contrast-enhanced computed tomography (CECT) and subsequent angiograms revealed a giant PSA at the disrupted, distal right AA. There were collateral flows to the brachial artery from the proximal to the right AA. To preserve collateral flows to the brachial artery, selective embolization of the inflow artery that derived from the distal AA was performed with hydrogel-coated coils. The post-embolization arteriogram showed no flow into the PSA, but collateral flows to the brachial artery we preserved. The post-embolization course was uneventful. The patient regained warmth in her right arm and hand on post-embolization day 4. Repeat CECT on post-embolization day 9 confirmed blood-flow to her right radial artery. CONCLUSIONS While a stent-graft should be used if the AA trunk can be preserved, coil embolization should be considered for PSA if the AA trunk is disrupted but collaterals are preserved.
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Affiliation(s)
- Naoki Oka
- Emergency and Critical Care Center, Kurashiki Central Hospital, 1-1-1 Miwa Kurashiki, Okayama, 710-8602, Japan
| | - Akira Kuriyama
- Emergency and Critical Care Center, Kurashiki Central Hospital, 1-1-1 Miwa Kurashiki, Okayama, 710-8602, Japan.
| | - Yukio Ishisaka
- Department of Diagnostic Radiology, Kurashiki Central Hospital, Okayama, Japan
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Derakhshanfar A, Bazrafshan M. Axillary Artery Pseudoaneurysm due to Bullet Injury: Open Surgery of Lesion. Indian J Surg 2021. [DOI: 10.1007/s12262-021-02717-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
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Kanda D, Imagama I, Imoto Y, Ohishi M. Bidirectional endovascular treatment for axillary artery injury secondary to proximal humerus fracture: a case report. EUROPEAN HEART JOURNAL-CASE REPORTS 2021; 5:ytaa526. [PMID: 33604507 PMCID: PMC7876303 DOI: 10.1093/ehjcr/ytaa526] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 09/14/2020] [Accepted: 11/27/2020] [Indexed: 11/14/2022]
Abstract
Background Axillary artery injury secondary to proximal humerus fracture is a rare but serious complication. The management of this injury has traditionally involved surgical treatment. Case summary A 66-year-old female with gait disturbance slipped and fell off her wheelchair at home. She presented to a local hospital with right shoulder pain and was subsequently urgently transferred to our hospital by helicopter because of suspicion of axillary artery injury. Computed tomography angiography revealed disruption of the right axillary artery. We decided to perform endovascular treatment instead of surgical treatment for axillary artery injury. However, since endovascular treatment via the right femoral artery was impossible, we performed bidirectional (right femoral and right brachial artery approaches) endovascular treatment. We expanded the occluded lesion using a 3.5 mm × 40 mm sized balloon and placed a 5.0 mm × 50 mm stent graft (Gore® Viabahn®) across the lesion. The final subclavian injection confirmed that distal flow to the brachial artery was preserved and that there was no leakage of contrast medium from the axillary artery. Discussion We performed endovascular treatment for axillary artery injury secondary to proximal humerus fracture. Although surgical repair is typically performed for this kind of injury, our experience suggests that endovascular treatment might be an option in patients with axillary artery injury.
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Affiliation(s)
- Daisuke Kanda
- Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima City, Kagoshima 890-8520, Japan
| | - Itsumi Imagama
- Department of Cardiovascular and Gastroenterological Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima City, Kagoshima 890-8520, Japan
| | - Yutaka Imoto
- Department of Cardiovascular and Gastroenterological Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima City, Kagoshima 890-8520, Japan
| | - Mitsuru Ohishi
- Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima City, Kagoshima 890-8520, Japan
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Axillary artery injury from a closed humeral neck fracture: A case report. ACTA ACUST UNITED AC 2016; 41:407-411. [PMID: 27745944 DOI: 10.1016/j.jmv.2016.07.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Accepted: 07/01/2016] [Indexed: 11/22/2022]
Abstract
Axillary artery injury from humeral neck fracture is an uncommon event. Vascular damage due to these injuries may threaten limb loss. In some cases, the signs of ischemia may not be evident just after the injury and may only appear later on. Therefore, a high index of suspicion is essential. It is important to bear this association in mind, so as to make an early diagnosis and avoid serious complications. We are describing the case of a young patient involved in a motor vehicle crash with an axillary artery trauma due to the surgical neck of humerus fracture. The patient underwent a basilic vein grafting, the postoperative course was good.
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Ierardi AM, Kehagias E, Piffaretti G, Piacentino F, De Marchi G, Tozzi M, Ioannou C, Tonolini M, Magenta Biasina A, Carrafiello G, Tsetis D. ePTFE stent graft in non-steno-occlusive arterial disease: 2 centers retrospective study. Radiol Med 2016; 121:482-93. [DOI: 10.1007/s11547-016-0623-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Accepted: 01/19/2016] [Indexed: 11/30/2022]
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Wang W, Liu X, Lu M. Case-report: endovascular treatment of aortic pseudo-aneurysm caused by Fishbone. J Cardiothorac Surg 2015; 10:94. [PMID: 26152238 PMCID: PMC4494703 DOI: 10.1186/s13019-015-0304-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2014] [Accepted: 06/29/2015] [Indexed: 01/08/2023] Open
Abstract
Aortic pseudo-aneurysm (APA) is a rare disease in clinic. Because of its relative rarity, we are far from making any conclusion regarding the natural history and appropriate therapeutic strategy for this condition. This study is to investigate the treatment effect of interventional therapy in aortic pseudo-aneurysm. A woman of 68 years old diagnosed with APA caused by fishbone was treated with stent grafts. After treatment, the therapeutic effect was assessed by measuring the size of trauma. The patient recovered well after stent grafts treatment, as her trauma was minimal. However, some complications of intravascular interventional treatment were observed. Compared with conventional surgery, interventional therapy of intravascular stent grafts has its merits. Therefore, this strategy was worthy to apply in the treatment of aortic pseudo-aneurysm.
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Affiliation(s)
- Wei Wang
- Department of Cardiology, the First Affiliated Hospital of Guangzhou Medical University, No.151 Yanjiang West Road, Guangzhou, 510120, China.
| | - Xuesong Liu
- Department of Cardiology, the First Affiliated Hospital of Guangzhou Medical University, No.151 Yanjiang West Road, Guangzhou, 510120, China.
| | - Mingjun Lu
- Department of Cardiology, the First Affiliated Hospital of Guangzhou Medical University, No.151 Yanjiang West Road, Guangzhou, 510120, China.
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Chen L, Peng F, Wang T, Chen D, Yang J. Traumatic pseudoaneurysm of axillary artery combined with brachial plexus injury. PLoS One 2014; 9:e113099. [PMID: 25412426 PMCID: PMC4239043 DOI: 10.1371/journal.pone.0113099] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2014] [Accepted: 10/19/2014] [Indexed: 11/19/2022] Open
Abstract
Traumatic pseudoaneurysm of the axillary artery combined with brachial plexus injury is extremely rare. The factors that influence the symptoms and functional recovery related to this condition are unclear. Nine patients who had sustained this trauma were surgically treated at our unit between June 1999 and November 2010. The cause of trauma, symptoms, signs and examinations of neurological and vascular deficits, and the surgical findings of the involved nerves and vessels were recorded in detail. The functional recovery of vessels and nerves, as well as the extent of pain, were evaluated, respectively. The average length of patient follow-up was 4.5 years (range, 24 months to 11.3 years). After vessel repair, whether by endovascular or operative treatment, the distending, constant, and pulsating pain was relieved in all patients. Furthermore, examination of the radial artery pulse on the repaired side appeared normal at last follow-up. All patients showed satisfactory sensory recovery, with motor recovery rated as good in five patients and fair in four patients. The symptom characteristics varied with the location of the damage to the axillary artery. Ultrasound examination and computed tomography angiography are useful to evaluate vascular injury and provide valuable information for operative planning. Surgical exploration is an effective therapy with results related to the nerve injury condition of the brachial plexus.
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Affiliation(s)
- Lin Chen
- Department of Hand Surgery, Huashan Hospital, Fudan University, Shanghai, China
- Key Laboratory of Hand Reconstruction, Ministry of Health, Shanghai, China
- Key Laboratory of Peripheral Nerve and Microsurgery, Shanghai, China
| | - Feng Peng
- Department of Hand Surgery, Huashan Hospital, Fudan University, Shanghai, China
- Key Laboratory of Hand Reconstruction, Ministry of Health, Shanghai, China
- Key Laboratory of Peripheral Nerve and Microsurgery, Shanghai, China
- * E-mail:
| | - Tao Wang
- Department of Hand Surgery, Huashan Hospital, Fudan University, Shanghai, China
- Key Laboratory of Hand Reconstruction, Ministry of Health, Shanghai, China
- Key Laboratory of Peripheral Nerve and Microsurgery, Shanghai, China
| | - Desong Chen
- Department of Hand Surgery, Huashan Hospital, Fudan University, Shanghai, China
- Key Laboratory of Hand Reconstruction, Ministry of Health, Shanghai, China
- Key Laboratory of Peripheral Nerve and Microsurgery, Shanghai, China
| | - Jianyun Yang
- Department of Hand Surgery, Huashan Hospital, Fudan University, Shanghai, China
- Key Laboratory of Hand Reconstruction, Ministry of Health, Shanghai, China
- Key Laboratory of Peripheral Nerve and Microsurgery, Shanghai, China
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Park SK, Hwang JK, Park SC, Kim SD. Endovascular treatment of a spontaneous aneurysm in the axillary artery. Interact Cardiovasc Thorac Surg 2014; 20:140-2. [PMID: 25246010 DOI: 10.1093/icvts/ivu308] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Spontaneous aneurysm in the axillary artery is extremely rare. The standard treatment for axillary artery aneurysm has been surgical repair, but endovascular management of select aneurysms using stent grafts has become more prevalent with the development of endoluminal technology. We report the case of a 36-year old man with a spontaneous aneurysm in the axillary artery. He experienced a tingling sensation and intermittent pain in the left upper extremity and had no history of trauma to the axilla. We performed endovascular treatment [placement of a Viabahn stent graft (W.L. Gore & Associates, Flagstaff, AZ, USA)] for a spontaneous aneurysm in the axillary artery. Following the procedure, his symptoms disappeared completely. After 6, 12 and 24 months, we carried out computed tomography angiography; all scans showed no complications. Now, the patient has no symptoms related to aneurysm in the axilla.
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Affiliation(s)
- Sung Kyun Park
- Department of Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jeong Kye Hwang
- Department of Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Sun Cheol Park
- Department of Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Sang Dong Kim
- Department of Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea
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Cawich SO, Harnarayan P, Budhooram S, Naraynsingh V. Axillary Artery Injury Accompanying Humeral Neck Fracture. Int J Angiol 2014; 24:296-9. [PMID: 26648673 DOI: 10.1055/s-0034-1372246] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
Injuries to the axillary artery from proximal humeral fractures are uncommon. There are only 66 such injuries reported across the world literature to date. We report an additional case of axillary artery injury. This case highlights the importance of maintaining a high index of suspicion to prevent diagnostic delay.
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Affiliation(s)
- Shamir O Cawich
- Department of Clinical Surgical Sciences, University of the West Indies, St. Augustine, Trinidad and Tobago
| | - Patrick Harnarayan
- Department of Clinical Surgical Sciences, University of the West Indies, St. Augustine, Trinidad and Tobago
| | - Steve Budhooram
- Department of Clinical Surgical Sciences, University of the West Indies, St. Augustine, Trinidad and Tobago
| | - Vijay Naraynsingh
- Department of Clinical Surgical Sciences, University of the West Indies, St. Augustine, Trinidad and Tobago
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Saad N, Bentalha A, Thar A, Benjelloun MY, Oulahyane R, Mossadik A, El Koraichi A, El Kettani S. Spontaneous rupture of a posttraumatic aneurysm of the axillary artery-a rare cause of hemorrhagic shock in children. Ann Vasc Surg 2014; 28:1792.e15-7. [PMID: 24704582 DOI: 10.1016/j.avsg.2014.03.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2014] [Revised: 03/09/2014] [Accepted: 03/10/2014] [Indexed: 10/25/2022]
Abstract
Posttraumatic aneurysms of the axillary artery are extremely scarce. In pediatrics, no similar case has been described. Injuries of axillary artery are often associated with ischemic complications, whereas the bleeding risks are not well documented. We report the case of a 5-year-old boy who was admitted with a scapular pulsatile lump 2 weeks after a domestic accident. During his stay, he suddenly presented a hemorrhagic shock. The patient was immediately admitted to the operating room to undergo surgical hemostasis and was then transferred to intensive care unit to stabilize his vital functions. This case shows the possibility of spontaneous and life-threatening acute bleeding of posttraumatic aneurysms of the axillary artery.
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Affiliation(s)
- Nabil Saad
- Pediatric ICU, Children Hospital, Rabat, Morocco
| | - Aziza Bentalha
- School of Medicine, Mohamed V University, Rabat, Morocco
| | | | | | - Rachid Oulahyane
- Pediatric ICU, Children Hospital, Rabat, Morocco; Pediatric General Surgery Department, Children Hospital, Rabat, Morocco
| | - Ahlam Mossadik
- Pediatric ICU, Children Hospital, Rabat, Morocco; School of Medicine, Mohamed V University, Rabat, Morocco
| | - Alae El Koraichi
- Pediatric ICU, Children Hospital, Rabat, Morocco; School of Medicine, Mohamed V University, Rabat, Morocco.
| | - Salma El Kettani
- Pediatric ICU, Children Hospital, Rabat, Morocco; School of Medicine, Mohamed V University, Rabat, Morocco
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Morisaki K, Kuma S, Okazaki J. Recurrent brachial artery embolism caused by a crutch-induced axillary artery aneurysm: report of a case. Surg Today 2013; 44:1355-8. [DOI: 10.1007/s00595-013-0642-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2012] [Accepted: 01/16/2013] [Indexed: 10/26/2022]
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13
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Mazzaccaro D, Malacrida G, Occhiuto MT, Stegher S, Tealdi DG, Nano G. Endovascular treatment of iatrogenic axillary artery pseudoaneurysm under echographic control: a case report. J Cardiothorac Surg 2011; 6:78. [PMID: 21619625 PMCID: PMC3123554 DOI: 10.1186/1749-8090-6-78] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2011] [Accepted: 05/27/2011] [Indexed: 11/10/2022] Open
Abstract
Aim Brief case report of the treatment of a large axillary artery pseudoaneurysm after a pacemaker using a left brachial cutdown and a retrograde delivery of a covered stent using ultrasound and fluoroscopic guidance. The patient's renal function precluded the use of contrast materials. Case Report A 77 years old man presenting with acute renal failure and haemoglobin decrease arrived with an expanding pseudoaneurysm of the left axillary artery from a pacemaker placement. Considering the site of the lesion and patient's comorbidities, under echographic control, a Hemobahn® stent-graft was placed; fluoroscopy assisted manipulation of guidewires and sheaths into the aortic arch. The procedure was successfully ended without any complications. At 8 months the stent graft was still patent. Conclusion Ultrasound guidance may represent an alternative for pseudo-aneurysm exclusion without any use of contrast medium, especially in those patient where lesions are easily detectable using ultrasonography and when comorbidities contraindicate aggressive surgical or angiographic approach.
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Endovascular treatment of ruptured axillary and large internal mammary artery aneurysms in a patient with Marfan syndrome. J Vasc Surg 2010; 53:478-82. [PMID: 21050698 DOI: 10.1016/j.jvs.2010.08.076] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2010] [Revised: 08/18/2010] [Accepted: 08/25/2010] [Indexed: 11/23/2022]
Abstract
Marfan syndrome is an autosomally inherited disorder affecting the synthesis of connective tissues. Vascular manifestations of Marfan syndrome include aneurysmal dilatation of the aortic root, aortic dissection, and rupture. Peripheral aneurysms are mostly reported in the iliac, femoral, and subclavian arteries. We report a Marfan patient with a ruptured axillary artery aneurysm and a large left internal mammary artery aneurysm. The axillary aneurysm was successfully excluded using covered stent grafts, and the left internal mammary artery aneurysm was effectively coiled. Duplex ultrasound imaging at 4 months and computed tomography at 9 months demonstrated complete thrombosis and exclusion of both aneurysms with patent subclavian-axillary stent grafts.
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Stefańczyk L, Czeczotka J, Elgalal M, Sapieha M, Rowiński O. A Large Posttraumatic Subclavian Artery Aneurysm Complicated by Artery Occlusion and Arteriobronchial Fistula Successfully Treated Using a Covered Stent. Cardiovasc Intervent Radiol 2010; 34 Suppl 2:S146-9. [DOI: 10.1007/s00270-010-9959-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2010] [Accepted: 07/13/2010] [Indexed: 11/24/2022]
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Weger N, Klaassen Z, Sturt C, Hertz S. Endovascular Treatment of a Pseudoaneurysm After an Iatrogenic Axillary Artery Injury. Ann Vasc Surg 2010; 24:826.e9-12. [PMID: 20471203 DOI: 10.1016/j.avsg.2009.12.019] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2009] [Revised: 10/31/2009] [Accepted: 12/20/2009] [Indexed: 11/24/2022]
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Grover A. Response to the Article Entitled “Endovascular Repair of a Traumatic Axillary Artery Pseudoaneurysm,” by R. M. Kumar et al. Cardiovasc Intervent Radiol 2010; 33:660-1; author reply 662. [DOI: 10.1007/s00270-009-9712-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Reddy S. Reply to the Queries Regarding Our Article Entitled “Endovascular Repair of a Traumatic Axillary Artery Pseudoaneurysm”. Cardiovasc Intervent Radiol 2010. [DOI: 10.1007/s00270-009-9713-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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