Endovascular Treatment of an Aneurysmal Aberrant Right Subclavian Artery

Abstract

Purpose:

To describe combined endovascular and surgical management of a complex aneurysmal aberrant right subclavian artery (RSA).

Case Report:

A 75-year-old obese man with severe chronic obstructive pulmonary disease was referred for treatment of a 6.8-cm aneurysm of an aberrant right subclavian artery. A stent-graft was deployed in the proximal part of the descending aorta to cover the origin of the dilated aberrant RSA, and then a venous carotid-subclavian bypass was made to restore blood flow in the right arm. In a second stage, the prevertebral segment of the aberrant RSA was embolized to avoid retrograde perfusion of the aneurysm.

Conclusions:

Combined endovascular and surgical treatment of an aneurysmal aberrant subclavian artery is feasible, safe, and effective. This less invasive approach could be the treatment of choice in high-risk patients.

Keywords

arteria lusoria aneurysm subclavian artery Talent thoracic stent-graft carotid-subclavian bypass coil embolization

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References

Stewart

Kincaid

Edwards

. An Atlas of Vascular Rings and Related Malformations of the Aortic Arch System. Springfield, IL: Charles C. Thomas, 1964.

Austin

Wolfe

. Aneurysm of aberrant subclavian artery with a review of the literature. J Vasc Surg. 1985; 2: 571–577.

Kieffer

Bahnini

Koskas

. Aberrant subclavian artery: Surgical treatment in thirty-three adult patients. J Vasc Surg. 1994; 19: 100–111.

Esposito

Khalil

Galloway

. Surgical treatment for aneurysm of aberrant subclavian artery based on a case report and a review of the literature. J Thorac Cardiovasc Surg. 1988; 95: 888–891.

Myers

Gomes

. Management of aberrant subclavian artery aneurysms. J Cardiovasc Surg. 2000; 41: 607–612.

Davidian

Kee

Kato

. Aneurysm of an aberrant right subclavian artery: Treatment with PTFE covered stent-graft. J Vasc Surg. 1998; 28: 335–339.

Mitchell

Dake

Semba

. Endovascular stent-graft repair of thoracic aortic aneurysms. J Thorac Cardiovasc Surg. 1996; 111: 1054–1062.

Kouchoukos

Dougenis

. Surgery of the thoracic aorta. N Engl J Med. 1997; 26: 1876–1888.

Görich

Asquan

Seifarth

. Initial experience with intentional stent-graft coverage of the subclavian artery during endovascular thoracic aortic repairs. J Endovasc Ther. 2002; 9(suppl II): II-39–II-43.

10.

Hausegger

Oberwalder

Tiesenhausen

. Intentional left subclavian artery occlusion by thoracic aortic stent-grafts without surgical transposition. J Endovasc Ther. 2001; 8: 472–476.