Chronic type B aortic dissection with the right aortic arch was rare. We present the case of a 59-year-old man with a right aortic arch and chronic type B aortic dissection, with a maximum size of 80 mm. Graft replacement was successfully performed through right anterolateral thoracotomy with partial sternotomy through the fourth intercostal space. The patient's postoperative course was uneventful. He had no paralysis and was extubated on postoperative day 2 and discharged from the hospital on postoperative day 15. Anterolateral thoracotomy with partial sternotomy could be a suitable approach for right-sided aortic aneurysms.

Background If the internal thoracic artery is a collateral circulation to the lower extremities, careful consideration should be given to its use when coronary artery bypass grafting is required. We report a case of CABG with bilateral common iliac artery lesions and collateral circulation from the bilateral ITAs on the peripheral side. Case presentation A 58-year-old man was admitted to our department with claudication and dyspnea upon exertion. He was diagnosed with right common iliac artery obstruction and 90% stenosis of the left common iliac artery. Coronary angiography revealed three-vessel disease with 50% stenosis of the left main trunk. The bilateral ITA showed a rich collateral flow to the lower extremities. Hybrid single staged repair with percutaneous transluminal angioplasty for the left iliac lesion was performed, followed by off-pump coronary artery bypass grafting (CABG) and femoro-femoral crossover bypass. Postoperative angiography revealed that all grafts were patent. The postoperative course was uneventful, except that the patient’s creatinine kinase level increased to 7177 U/L on postoperative day 1. Conclusion To treat coronary artery disease with peripheral artery disease, especially those with iliac artery occlusion lesions with collateral circulation from the ITA, not only graft selection but also the treatment strategies for peripheral lesions are considered extremely important. Hybrid single staged coronary and lower limb artery revascularization could be safely achieved by multidisciplinary team strategies.

A 76-year-old female was had dyspnea on effort and was diagnosed with pulmonary thromboembolism. She had pulmonary thromboembolism and deep vein thrombosis on computed tomography, and inferior vena cava (IVC) filter was placed. 10 days after IVC filter implantation, she suffered from low back pain. Computed tomography showed a retroperitoneal hematoma. Angiography was performed emergently and demonstrated a pseudoaneurysm at the fourth lumbar artery. Embolization of the lumbar artery was performed with coils. Lumbar artery pseudoaneurysm due to IVC filter implantation is a rare, but it is important to recognize the possibility of that complication.