Two-stage surgical and endovascular treatment of an aneurysmal aberrant right subclavian (Lusoria) artery

Abstract

We report a case of a 75-year-old male patient with an asymptomatic aneurysm of an aberrant right subclavian artery (ARSA). Timely elective therapy of this entity is indicated due to the high risk of rupture. Because of the patient's reduced physical state, we performed an interdisciplinary endovascular aortic stent-grafting for the exclusion of the ARSA aneurysm. However, the proximal landing zone for the thoracic stent had to be chosen proximal to the origin of the left subclavian artery. Thus, 2 days before the endovascular procedure, a left-sided carotido-subclavian bypass was accomplished. The peri- and postoperative course was uneventful. The technical results in our patient were excellent, no leakage was visible so far.

Retro-oesophageal right subclavian artery in association with thyroid ima artery: a case report, clinical impact and review of the literature

“…Surgical repair is mandatory in aneurysm cases [59] [54], authors incorrectly describe their finding as being an inferior thyroid artery instead of an IMA; LCCA -left common carotid artery; RCCA -right common carotid artery; NRLN -non recurrent laryngeal nerve; RLN -recurrent laryngeal nerve; RVA -right vertebral artery in order to avoid further serious or even fatal complications [12]. A combined endovascular and surgical treatment was reported [38], while minimally invasive surgical and endovascular techniques have also been suggested as repair methods [6,17]. Davidian et al [19] accomplished the first successful treatment of an RERSA aneurysm using a polytetrafluoroethylene covered stent graft.…”

Retroesophageal Right Subclavian Artery with Nonrecurrent Laryngeal Nerve: Unique Variation of Surgical Importance

“…31 On the left side, NRLN is seen in cases of dextrocardia. 31 Commonly, NRLN is diagnosed first and arteria lusoria is rarely suspected in cases of dysphagia. 32 Preoperative diagnosis of a NRLN is difficult using CT scan or magnetic resonance imaging (MRI) but visualizing the coexisting arterial anomaly arteria lusoria gives a lead to possible diagnosis.…”

“…22,30 The incidence of arteria lusoria globally is 0.5 to 2% and is defined as the right subclavian artery arising as a branch of normal aortic arch and passing upward to the right behind the esophagus. 31 The anomaly is usually asymptomatic but sometimes presents as dysphagia called as dysphagia lusoria due to arterial tortuosity or premature arteriosclerosis and a rarely an aneurysm is seen. 31 On the left side, NRLN is seen in cases of dextrocardia.…”

“…31 The anomaly is usually asymptomatic but sometimes presents as dysphagia called as dysphagia lusoria due to arterial tortuosity or premature arteriosclerosis and a rarely an aneurysm is seen. 31 On the left side, NRLN is seen in cases of dextrocardia. 31 Commonly, NRLN is diagnosed first and arteria lusoria is rarely suspected in cases of dysphagia.…”

Aberrant Right Subclavian Artery Syndrome and Chronic Cough

“…Anevrizmanın rüptürü olasılığı mevcuttur ve bu durumun %30 mortaliteye neden olması nedeniyle saptanması önemlidir (10). Geleneksel operasyon yöntemleri ile yüksek mortalite oranları bildirilmesi nedeniyle son zamanlarda endovasküler tedavi yöntemleri önerilmektedir (11).…”