Staphylococcus aureus-associated infected subclavian artery pseudoaneurysm treated with dual bare-metal stent implantation: a case report

Q: What is the clinical evidence from this study?

Study design: Case Report. Population: Methicillin-sensitive Staphylococcus aureus-associated infected left subclavian artery pseudoaneurysm (n=1). Intervention: Endovascular dual bare-metal stent implantation with prolonged antimicrobial therapy. Primary outcome: Aneurysm sac thrombosis, occlusion, and shrinkage with resolution of hemoptysis and infection control.

Q: What does this research mean for the field?

Dual bare-metal stent implantation combined with long-term antimicrobial therapy is a feasible treatment to achieve pseudoaneurysm thrombosis and sac shrinkage in infected subclavian artery pseudoaneurysms while preserving vertebral artery perfusion. Novelty: ClaimNovelty.NOVEL_FINDING. Consensus alignment: ConsensusAlignment.NEUTRAL.

Ruihua Li; Shuohao Shen; Yuanbin Cao; Jianjun Jiang; 丁祥就

doi:10.3389/fcvm.2026.1965965

October 22, 2026Frontiers in Cardiovascular MedicineOpen Access

Staphylococcus aureus-associated infected subclavian artery pseudoaneurysm treated with dual bare-metal stent implantation: a case report

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Key result

Dual bare-metal stenting with antibiotics achieves complete pseudoaneurysm thrombosis and shrinks sac to ~20 mm.

n=1

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Why the study?

Infected subclavian artery aneurysms are exceedingly rare, life-threatening vascular lesions associated with high risks of rupture and mortality.

Key Points

To describe the endovascular management of an infected left subclavian artery pseudoaneurysm adjacent to a dominant vertebral artery using dual bare-metal stents.
Evaluated a 70-year-old male presenting with intermittent hemoptysis diagnosed with methicillin-sensitive Staphylococcus aureus bacteremia and an infected subclavian artery pseudoaneurysm.
Implanted overlapping dual bare-metal stents across the parent vessel to preserve vertebral artery perfusion and enable intrasac antibiotic penetration, while deliberately withholding antithrombotic therapy.
Administered a staged 12-month antimicrobial regimen consisting of 4 weeks of intravenous cefazolin followed by oral cephalosporin suppressive maintenance.
Hemoptysis completely resolved following the dual bare-metal stent intervention.
Follow-up imaging demonstrated complete thrombosis and occlusion of the aneurysm sac at 3 months, with marked sac shrinkage confirmed at 6 months.
Sustained infection control was maintained at 12-month follow-up without recurrent bacteremia or ischemic complications after discontinuing suppressive antibiotics.

Study Design

Type

Case Report (n=1)

Multicenter

No

Structured PICO

P

Population

A 70-year-old male with a 30-mm methicillin-sensitive Staphylococcus aureus-infected left subclavian artery pseudoaneurysm presenting with hemoptysis, followed for 12 months.

I

Intervention

Endovascular repair with two overlapping 14 mm x 60 mm bare-metal stents (Smart Control, Cordis) via left radial artery approach, withholding of postoperative systemic antithrombotic therapy, and a staged 12-month antimicrobial regimen (empirical IV ceftriaxone 2 g once daily and vancomycin 1 g every 12 h switched to targeted IV cefazolin 2 g every 8 h for 4 weeks, followed by oral cefuroxime axetil 500 mg twice daily to complete 12 months).

O

Outcome

Clinical resolution of hemoptysis, complete thrombosis and occlusion of the aneurysm sac at 3 months, sac shrinkage at 6 months, and sustained infection control at 12 months follow-up.surrogate

Limitations

Single-case report with limited generalizability
Long-term safety and efficacy lack large-scale validation, and late complications cannot be excluded
Definite primary source of infection could not be confirmed
Decision to withhold antithrombotic therapy relied on individualized risk-benefit assessment without high-level evidence
Optimal duration of suppressive antibiotics after endovascular treatment remains undefined
Long-term safety lacks large-scale validation and late complications (recurrent infection, stent biofilm formation, pseudoaneurysm recurrence, delayed rupture) cannot be excluded

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Implication

Overlapping dual bare-metal stent implantation combined with prolonged 12-month antimicrobial therapy may offer a feasible endovascular alternative to preserve side-branch perfusion and achieve sac thrombosis in highly selected patients with infected subclavian artery pseudoaneurysms who decline open surgical repair.

Abstract

Infected subclavian artery aneurysms are exceedingly rare, life-threatening vascular lesions associated with high risks of rupture and mortality. We report a 70-year-old male presenting with intermittent hemoptysis, who was diagnosed with a pseudoaneurysm of the left subclavian artery adjacent to the dominant vertebral artery. Blood cultures confirmed methicillin-sensitive Staphylococcus aureus infection. The patient underwent endovascular repair with dual bare-metal stents to preserve vertebral artery perfusion. Hemoptysis completely resolved post-intervention. Complete thrombosis and occlusion of the aneurysm sac were achieved at the 3-month follow-up, with remarkable sac shrinkage observed at 6 months. This case suggests that dual bare-metal stents may represent a feasible potential treatment alternative for highly selected patients with infected subclavian artery aneurysms. Long-term safety and efficacy remain to be further verified. Long-term antimicrobial therapy and close surveillance remain mandatory.

Discussion

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Cite This Study

Li et al. (2026) conducted a case report in Methicillin-sensitive Staphylococcus aureus-associated infected left subclavian artery pseudoaneurysm (n=1). Endovascular dual bare-metal stent implantation with prolonged antimicrobial therapy was evaluated on Aneurysm sac thrombosis, occlusion, and shrinkage with resolution of hemoptysis and infection control. Dual bare-metal stent implantation with 12-month antimicrobial therapy achieved complete pseudoaneurysm thrombosis at 3 months and sac reduction from 30 mm to 20 mm at 6 months.

synapsesocial.com/papers/6aee6b8671a7594806220a21 https://doi.org/10.3389/fcvm.2026.1965965

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Staphylococcus aureus-associated infected subclavian artery pseudoaneurysm treated with dual bare-metal stent implantation: a case report

Figures

Key Points

Study Design

Structured PICO

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Staphylococcus aureus-associated infected subclavian artery pseudoaneurysm treated with dual bare-metal stent implantation: a case report

Figures

Key Points

Study Design

Structured PICO

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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