Endovascular treatment of an aneurysmal aberrant right subclavian artery.

PURPOSE: To describe combined endovascular and surgical management of a complex aneurysmal aberrant right subclavian artery (RSA). CASE REPORT: A 75-year-old obese man with severe chronic obstructive pulmonary disease was referred for treatment of a 6.8-cm aneurysm of an aberrant right subclavian artery. A stent-graft was deployed in the proximal part of the descending aorta to cover the origin of the dilated aberrant RSA, and then a venous carotid-subclavian bypass was made to restore blood flow in the right arm. In a second stage, the prevertebral segment of the aberrant RSA was embolized to avoid retrograde perfusion of the aneurysm. CONCLUSIONS: Combined endovascular and surgical treatment of an aneurysmal aberrant subclavian artery is feasible, safe, and effective. This less invasive approach could be the treatment of choice in high-risk patients.