Sage Journals: Discover world-class research

Abstract

Purpose:

To report the endovascular treatment of a relatively uncommon entity: an aortic type B dissection combined with an aberrant subclavian artery (SA).

Case Report:

A 59-year-old patient was admitted with chest pain and interscapular back pain. A transesophageal ultrasound and magnetic resonance angiography revealed a type B aortic dissection originating at the level of an aberrant SA orifice. After failure of medical therapy, the dissection was treated by transluminal implantation of an Excluder stent-graft covering the entry site of the dissection at the aberrant SA orifice. Prior to the endovascular procedure, a transposition of the aberrant SA to the right carotid artery was performed through a supraclavicular approach. The patient remains asymptomatic at 19 months after the endovascular repair.

Conclusions:

Endovascular repair of a type B aortic dissection in the presence of a lusorian artery appears to be a feasible, safe, and less invasive alternative to conventional surgery. The need for concurrent transposition of the SA remains to be determined.

Keywords

thoracic aorta arteria lusoria Excluder stent-graft vessel transposition

Get full access to this article

View all access options for this article.

References

DeBakey

. Surgical considerations of dissecting aneurysm of the aorta. Ann Surg. 1955;142:586–612.

Nonami

Tomosawa

Nishida

. Dissecting aortic aneurysm involving an anomalous right subclavian artery and isolated left vertebral artery: case report and review of the literature. J Cardiovasc Surg (Torino). 1998;39:743–746.

Pretre

von Segesser

. Aortic dissection. Lancet. 1997;349:1461–1464.

Dake

Miller

Semba

. Transluminal placement of endovascular stent-grafts for the treatment of descending thoracic aortic aneurysms. N Engl J Med. 1994;331:1729–1734.

Dake

Kato

Mitchell

. Endovascular stent-graft placement for the treatment of acute aortic dissection. N Engl J Med. 1999;340:1546–1552.

Tiesenhausen

Amann

Koch

. Endovascular stent-graft repair of acute thoracic aortic dissection—early clinical experiences. Thorac Cardiovasc Surg. 2001;49:16–20.

Bayford

. An account of singular case of obstructional deglutition. Mem Med Soc London. 1794;2:275.

Molz

Burri

. Aberrant subclavian artery (arteria lusoria): sex differences in the prevalence of various forms of the malformation. Evaluation of 1378 observations. Virchows Arch A Pathol Anat Histol. 1978;380:303–315.

Kieffer

Bahnini

Koskas

. Aberrant subclavian artery: surgical treatment in thirty-three adult patients. J Vasc Surg. 1994;19:100–109.

10.

Weinberger

Randall

Parker

. Involvement of an aberrant right subclavian artery in dissection of the thoracic aorta: diagnostic and therapeutic implications. AJR Am J Roentgenol. 1977;129:653–655.