Single-stage hybrid repair of a right subclavian artery aneurysm involving the origin of the right vertebral artery

Abstract

Subclavian artery aneurysms (SCAAs) consist of approximately 1% of all peripheral artery aneurysms. While the standard of treatment has been open surgical repair (OSR), endovascular methods are gaining traction – especially with high risk OSR candidates. Endovascular treatment of the subclavian artery (SCA) requires careful consideration of the vertebral arteries (VA) and Circle of Willis anatomy. We describe a case of a 79-year-old female who presented with a right extrathoracic proximal SCAA and associated neck mass. Our surgical approach consisted of a single-stage hybrid operation: 1) RVA-RCCA (common carotid artery) transposition, and 2) RSCA covered stent placement. On follow-up, the patient was doing well, and imaging demonstrated a patent RVA, excluded RSCAA, and no endoleaks. Our hybrid approach is a reasonable alternative for patients who cannot undergo traditional OSR.

Keywords

• Right subclavian artery aneurysm
• Right extrathoracic proximal subclavian artery aneurysm
• Right common carotid artery – right vertebral artery transposition
• Right subclavian artery endovascular prosthesis