Case 292 Medical History A 79-year-old female patient reports a pulsatile, painful and progressively growing mass located in the supraclavicular left region during hospitalization due to urgent dialysis 2 months ago. Her hospitalization summary describes an attempt to implant a double lumen catheter in left subclavian vein and deep vein thrombosis in left upper limp, with warfarin as the chosen option for long-term anticoagulant therapy. She is also with Chronic Kidney Disease, hypertension and diabetes, she does not smoke or drink alcohol. Chest CT scan was requested (images). Chest CT, axial section, without intravenous injection of iodinated contrast medium. Chest CT, coronal reconstruction, after intravenous injection of iodinated contrast medium. Question:Analyzing the clinical case and the images presented, what is the diagnosis? Hematoma in the supraclavicular region. Pseudoaneurysm in the subclavian artery. Thrombosis in the subclavian artery. Arteriovenous fistula. Test Question (Residência Médica – UFT 2015)Endovascular procedures are performed minimally invasively. Regarding complications of endovascular procedures, which of the alternatives is FALSE? Anterograde dissections are usually self-limited, requiring no treatment. In cases of clinical signs of hypovolemia without visible hematoma, consideration should be given to retroperitoneal haemorrhage. The appearance of arteriovenous fistulas is an uncommon complication, with a generally late onset. The presence of atheroma plaque in the vessel wall increases the risk of dissection. Pseudoaneurysm is a possible complication of the endovascular technique and a surgical approach may be necessary for its treatment. Time is Up! Time's up
