To report thoracic aortic stent-graft repair in a patient with abnormal aortic arch anatomy.
Case Report:
An anomalous right subclavian artery was covered with a stent-graft in a 38-year-old woman being treated for a false aneurysm after coarctation repair. The right arm became relatively ischemic, but was viable and managed conservatively.
Conclusions:
Aneurysms close to left or aberrant right subclavian arteries can be safely and effectively treated by endoluminal repair without the need for revascularization procedures; ischemic symptoms that develop are often mild and transient.
ZapataHEdwardsJETitusJL. Aberrant right subclavian artery with left aortic arch: Associated cardiac anomalies. Pediatr Cardiol.1993; 14: 159–161.
2.
WhiteGHYuWMayJ. Three-year experience with the White-Yu Endovascular-GAD Graft for transluminal repair of aortic and iliac aneurysms. J Endovasc Surg.1997; 4: 124–136.
3.
StoneWMBrewsterDCMoncureAC. Aberrant right subclavian artery: Varied presentations and management options. J Vasc Surg.1990; 11: 812–817.
4.
KonstantinovIEPugaFJ. Surgical treatment of persistent esophageal compression by an unusual form of right aortic arch. Ann Thorac Surg.2001; 72: 2121–2123.
5.
BallottaEBardiniRBottioT. Aberrant right subclavian artery. An original median cervical approach. J Cardiovasc Surg (Torino). 1996; 37: 571–573.
6.
AkersDLFowlRJPlettnerJ. Complications of anomalous origin of the right subclavian artery: Case report and review of the literature. Ann Thorac Surg.1991; 5: 385–388.
7.
DakeMDMillerDCSembaCP. Transluminal placement of endovascular stent-grafts for the treatment of descending thoracic aortic aneurysms. N Engl J Med.1994; 331: 1729–1734.
8.
GreenbergRKReschTNymanU. Endovascular repair of descending thoracic aortic aneurysms: An early experience with intermediate-term follow-up. J Vasc Surg.2000; 31: 147–156.
9.
WhiteRADonayreCEWalotI. Endovascular exclusion of descending thoracic aortic aneurysms and chronic dissections: Initial clinical results with the AneuRx device. J Vasc Surg.2001; 33: 927–934.
10.
WeinbergerGRandallPAParkerFB. 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.
11.
GörichJAsquanYSeifarthH. 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–II43.
12.
CriadoFJClarkNSBarnatanMF. Stent graft repair in the aortic arch and descending thoracic aorta: A 4-year experience. J Vasc Surg.2002; 36: 1121–1128.
TiesenhausenKHauseggerKAOberwalderP. Left subclavian artery management in endovascular repair of thoracic aortic aneurysms and aortic dissections. J Card Surg.2003; 18: 429–435.
15.
HuttonMWolfBBoyneN. A case report of intentional occlusion of an aberrant right subclavian artery during endovascular stent-graft repair of a descending aortic aneurysm. Eur J Vasc Endovasc Surg.2004; 27: 222–224.
