Hybrid procedure for a descending thoracic and subclavian artery aneurysm in a patient with previous abdominal aortic surgery: Case report

Introduction. Hybrid procedures represent staged or simultaneous endovascular and open surgical techniques in the treatment of complex pathologies of the thoracic and abdominal aorta. We are presenting a patient with previous abdominal aortic surgery in whom hybrid vascular procedure for descending aorta and left subclavian artery aneurysm was performed. Case Outline. A 63-year-old female patient was admitted for computed tomography angiography. Descending aorta aneurysm (7.6 cm) as well as aneurysm of the left subclavian artery (LSA) was noted. Eight years ago she underwent abdominal aortic aneurysm resection and aortoiliac bypass. Standard TEVAR (thoracic endovascular aortic repair) procedure couldn?t be done due to small dimensions of previous ?Y? graft (12.6 mm), so first we did LSA transposition and after three days hybrid procedure. After ?Y? graft exposure, anastomosis between the corps of ?Y? graft and tubular graft 10 mm was created and through this conduit thoracic stent-graft was placed followed by complete ?Y? graft replacement. After 6 months angiography showed regular postoperative findings. Conclusion. Combined surgical and endovascular procedures in thoracic aorta pathology treatment could be useful solutions with favorable outcome.

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Coarctation of the Aorta Associated with Left Subclavian Artery Aneurysm: A Case Report

The Heart Surgery Forum ◽

10.1532/hsf98.20061213 ◽

2007 ◽

Vol 10 (3) ◽

pp. E175-E176 ◽

Cited By ~ 1

Author(s):

Kaan Inan ◽

Onur Goksel ◽

Ibrahim Alp ◽

Tuncay Erden ◽

Melih Us ◽

...

Keyword(s):

Case Report ◽

Subclavian Artery ◽

Left Subclavian Artery ◽

Artery Aneurysm ◽

Coarctation Of The Aorta ◽

Subclavian Artery Aneurysm

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Carotid-Axillary Bypass and Debridement for a Mycotic Aneurysm of the Left Subclavian Artery

Vascular and Endovascular Surgery ◽

10.1177/15385744211068616 ◽

2022 ◽

pp. 153857442110686

Author(s):

Aanuoluwapo Obisesan ◽

Dustin Manchester ◽

Maggie Lin ◽

Raymond J. Fitzpatrick

Keyword(s):

Subclavian Artery ◽

Mycotic Aneurysm ◽

Left Subclavian Artery ◽

Muscle Flap ◽

Artery Aneurysm ◽

Pectoralis Muscle ◽

Flap Coverage ◽

Subclavian Artery Aneurysm ◽

Risk Of Rupture ◽

Multi Disciplinary Team

Mycotic subclavian aneurysms are rare, and their presence typically mandates urgent repair due to the associated high risk of rupture and mortality. A multi-disciplinary team effort is of utmost importance in ensuring favorable results. In this case report, we present a 79-year-old male with a rapidly enlarging mycotic left subclavian artery aneurysm secondary to a retrosternal abscess and left sternoclavicular septic arthritis, who underwent aneurysmal exclusion, a left carotid-left axillary bypass and pectoralis muscle flap coverage with a good outcome.

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Hybridizing the “Sandwich” and “Chimney” Techniques in the Endovascular Repair of Coarctation of the Aortic Arch and Postcoarctation Ectasia Concomitant with a Left Subclavian Artery Aneurysm

Annals of Vascular Surgery ◽

10.1016/j.avsg.2017.01.032 ◽

2017 ◽

Vol 44 ◽

pp. 418.e7-418.e12

Author(s):

Mingguang Zhang ◽

Hao Nie ◽

Xinyu Gui ◽

Jiang Shao ◽

Bao Liu ◽

...

Keyword(s):

Aortic Arch ◽

Subclavian Artery ◽

Endovascular Repair ◽

Left Subclavian Artery ◽

Artery Aneurysm ◽

Subclavian Artery Aneurysm

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VS09. Open Surgical Repair of an Extrathoracic Distal Left Subclavian Artery Aneurysm

Journal of Vascular Surgery ◽

10.1016/j.jvs.2019.04.416 ◽

2019 ◽

Vol 69 (6) ◽

pp. e272

Author(s):

Rebecca Ur ◽

Sherene Shalhub ◽

Stephanie Banning ◽

Lauren K. Manteghi ◽

Jonathan Revels ◽

...

Keyword(s):

Subclavian Artery ◽

Surgical Repair ◽

Left Subclavian Artery ◽

Artery Aneurysm ◽

Open Surgical Repair ◽

Subclavian Artery Aneurysm

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Hybrid Repair of an Isolated Left Subclavian Artery Aneurysm Associated with a Right-Sided Aortic Arch

Journal of Vascular Surgery ◽

10.1016/j.jvs.2013.10.027 ◽

2013 ◽

Vol 58 (6) ◽

pp. 1735-1736

Author(s):

Jason R. Crowner ◽

Mark A. Farber ◽

Raghuveer Vallabhaneni

Keyword(s):

Aortic Arch ◽

Subclavian Artery ◽

Left Subclavian Artery ◽

Artery Aneurysm ◽

Subclavian Artery Aneurysm ◽

Hybrid Repair

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Intravascular treatment of left subclavian artery aneurysm coexisting with aortic coarctation in an adult patient

Open Medicine ◽

10.1515/med-2017-0001 ◽

2017 ◽

Vol 12 (1) ◽

pp. 1-4

Author(s):

Ryszard Pogorzelski ◽

Tomasz Wołoszko ◽

Sadegh Toutounchi ◽

Patryk Fiszer ◽

Ewa Krajewska ◽

...

Keyword(s):

Stent Graft ◽

Subclavian Artery ◽

Aortic Coarctation ◽

Left Subclavian Artery ◽

Axillary Artery ◽

Artery Aneurysm ◽

Limb Ischemia ◽

Subclavian Artery Aneurysm ◽

Internal Mammary

AbstractCoexistence of aortic coarctation with aneurysm of subclavian artery is a uncommon situation and may require unusual treatment in patients.A 40-year-old patient diagnosed incidentally with left subclavian artery aneurysm coexisting with aortic coarctation. Patient was initially referred for hybrid treatment. Initially ostium of the left subclavian artery was covered with a stent-graft. Over a 30-month follow-up period aneurysm became thrombosed all the way up to the ostium of internal mammary artery. The patient did not present with neurological symptoms or signs of upper limb ischemia. Taking into consideration good blood supply to the axillary artery via reversed blood flow in the thyreocervical trunk, hence we decided not to proceed with cervicoaxillary bypass grafting.Implantation stent-graft into aorta coarctation with covering axillary artery is proper way of treatment and may need no other surgical procedures.

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