Use of Gore Thoracic Branch Endoprosthesis in the Management of Dysphagia Lusoria

Abstract

Introduction:

Dysphagia lusoria is a rare clinical condition resulting from the compression of the esophagus by an aberrant retroesophageal right subclavian artery, often associated with a Kommerell diverticulum. This report highlights 3 cases in which the Gore Thoracic Branch Endoprosthesis (TBE) was used in a single-stage hybrid procedure to successfully manage this condition.

Methods:

Three patients presented with symptoms ranging from progressive dysphagia to symptomatic airway obstruction. They underwent single-stage thoracic endovascular aortic repair with TBE to revascularize the left subclavian artery and exclude the proximal right subclavian artery, followed by right subclavian artery debranching with transposition to right common carotid artery.

Results:

All 3 patients achieved complete resolution of symptoms postoperatively with technical success on follow-up imaging.

Conclusion:

This report underscores the efficacy of the Gore TBE as a solution for addressing this complex vascular anomaly.

Clinical Impact

Aberrant arch configurations that need repair usually require complex extra-antomic debranching of head vessels and or adjunct endovascular maneuvers during TEVAR. Development of branched TEVAR devices have improved surgical approaches in complex aortic arch treatment. The technique described here utilizes the benefits of an off-the-shelf branched TEVAR device, the Gore TBE, in a single stage hybrid procedure to address an aortic pathology that often require multi-stage, multi-device treatment.