Endovascular Stent-Graft Repairs Iatrogenic Subclavian Vein Injury

Iatrogenic injury to the great vessels of the upper thorax remains a rare but potentially catastrophic complication of head and neck surgery, often requiring immediate and decisive intervention. The subclavian vein is particularly vulnerable due to its deep anatomical position beneath the clavicle and its proximity to vital structures, making traditional open surgical repair technically demanding [1, 2]. While established guidelines emphasize the importance of rapid multidisciplinary intervention in vascular trauma, the optimal management of venous injuries in confined operative fields is still evolving [3, 4]. Current evidence suggests that standard compression or simple removal of offending catheters often results in poor outcomes, necessitating more robust reconstructive strategies [5]. Recent advances in endovascular technology have expanded the toolkit for managing complex vascular pathologies, yet clinical data on the long-term durability of venous stenting in this specific anatomical region remain sparse [6, 7]. A new case study involving the emergency deployment of an 11 x 50 mm Viabahn self-expanding stent-graft now provides critical longitudinal evidence, demonstrating full vessel patency at a 2-year follow-up following acute subclavian venous perforation [1].