{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T09:44:08Z","timestamp":1778233448186,"version":"3.51.4"},"reference-count":20,"publisher":"BMJ","issue":"7","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2023,6,15]]},"published-print":{"date-parts":[[2023,7]]},"abstract":"<jats:p>We present an unusual case of ruptured subclavian artery pseudoaneurysm following hydrotherapy and shoulder massage session on a background of clavicle non-union.<\/jats:p>\n               <jats:p>Following a clavicle fracture 16 years ago, which was managed conservatively, a woman in her 30s presents over a decade later with a ruptured subclavian artery pseudoaneurysm.<\/jats:p>\n               <jats:p>The original midshaft clavicle fracture was sustained 16 years ago. Conservative management was agreed, and she was discharged. Six years ago, she developed a small subclavian artery pseudoaneurysm which was kept under surveillance for 12 months with no active intervention required.<\/jats:p>\n               <jats:p>Over the following years, she continued to have intermittent shoulder girdle discomfort and neuropathic symptoms. On this presentation, after a sports massage, she presented with rapid-onset supraclavicular and axillary swelling. This was diagnosed as a ruptured subclavian artery pseudoaneurysm and was treated with emergency radiological-guided stenting and subsequent internal fixation of the clavicle non-union.<\/jats:p>\n               <jats:p>The patient then attended regular orthopaedic and vascular follow-up to ensure her clavicle fracture unites and the graft remains patent.<\/jats:p>\n               <jats:p>We discuss the case presentation and management of this unusual injury.<\/jats:p>","DOI":"10.1136\/bcr-2022-253826","type":"journal-article","created":{"date-parts":[[2023,7,4]],"date-time":"2023-07-04T16:26:15Z","timestamp":1688487975000},"page":"e253826","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Ruptured subclavian artery pseudoaneurysm following a shoulder massage on a background of clavicle non-union"],"prefix":"10.1136","volume":"16","author":[{"given":"Jason","family":"Lawson","sequence":"first","affiliation":[{"name":"Vascular Surgery, St Mary's Hospital, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen","family":"Crockett","sequence":"additional","affiliation":[{"name":"Vascular Surgery, St Mary's Hospital, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dylan","family":"Griffiths","sequence":"additional","affiliation":[{"name":"Trauma & Orthopaedics, St Mary's Hospital, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Celia","family":"Riga","sequence":"additional","affiliation":[{"name":"Vascular Surgery, St Mary's Hospital, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sanjeeve","family":"Sabharwal","sequence":"additional","affiliation":[{"name":"Trauma & Orthopaedics, St Mary's Hospital, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert","family":"Thomas","sequence":"additional","affiliation":[{"name":"Interventional Radiology, St Mary's Hospital, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rishi","family":"Das","sequence":"additional","affiliation":[{"name":"Trauma & Orthopaedics, St Mary's Hospital, London, UK"},{"name":"Orthopaedic Research Institute of Queensland, Pimlico, Queensland, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2023,7,4]]},"reference":[{"key":"2025082802153882000_16.7.e253826.1","doi-asserted-by":"crossref","first-page":"1883","DOI":"10.1016\/j.jhsa.2009.10.012","article-title":"Displaced, comminuted diaphyseal clavicle fracture","volume":"34","author":"Bravo","year":"2009","journal-title":"J Hand Surg Am"},{"key":"2025082802153882000_16.7.e253826.2","doi-asserted-by":"crossref","first-page":"1345","DOI":"10.2106\/JBJS.16.01112","article-title":"The clavicle trial: a multicenter randomized controlled trial comparing operative with nonoperative treatment of displaced midshaft clavicle fractures","volume":"99","author":"Ahrens","year":"2017","journal-title":"J Bone Joint Surg Am"},{"key":"2025082802153882000_16.7.e253826.3","doi-asserted-by":"crossref","first-page":"557","DOI":"10.2106\/JBJS.19.00955","article-title":"Displaced midshaft clavicle fracture union can be accurately predicted with a delayed assessment at 6 weeks following injury: a prospective cohort study","volume":"102","author":"Nicholson","year":"2020","journal-title":"J Bone Joint Surg Am"},{"key":"2025082802153882000_16.7.e253826.4","doi-asserted-by":"crossref","first-page":"284","DOI":"10.1016\/j.avsg.2019.10.096","article-title":"Endovascular treatment of Subclavian artery Pseudoaneurysm","volume":"65","author":"Wang","year":"2020","journal-title":"Ann Vasc Surg"},{"key":"2025082802153882000_16.7.e253826.5","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1016\/j.jvs.2009.03.010","article-title":"Right subclavian pseudoaneurysm secondary to blunt trauma in an arteriovenous malformation","volume":"51","author":"Quinones-Baldrich","year":"2010","journal-title":"J Vasc Surg"},{"key":"2025082802153882000_16.7.e253826.6","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.1972.04180080184031"},{"key":"2025082802153882000_16.7.e253826.7","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-198906000-00007"},{"key":"2025082802153882000_16.7.e253826.8","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1016\/j.jvscit.2017.08.001","article-title":"Hybrid repair of a large pseudoaneurysm of the proximal right subclavian artery in a marfan patient","volume":"3","author":"van der Weijde","year":"2017","journal-title":"J Vasc Surg Cases Innov Tech"},{"key":"2025082802153882000_16.7.e253826.9","doi-asserted-by":"publisher","DOI":"10.1007\/s003300050340"},{"key":"2025082802153882000_16.7.e253826.10","unstructured":"Smith AA , Gupta N . 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