Delayed left subclavian artery pseudoaneurysm following transcatheter aortic valve implantation

In 10-15% of patients undergoing transcatheter aortic valve implantation (TAVI), the femoral artery approach is precluded owing to insufficient caliber or tortuosity of the vessel. In these subjects, the subclavian (SC) or the axillary (AX) access can be used; these have proved equivalent to the femoral artery approach in terms of both survival and the rate of vascular complications. The SC or AX approach usually require a surgical cut-down under general anesthesia or deep sedation, though cases have been described in which the percutaneous technique has been adopted. Furthermore, SC and AX access may be burdened by complications, such as vessel perforation or rupture, or the formation of aneurysms at the site of incision.