Aberrant subclavian artery: Surgical treatment in thirty-three adult patients

Kieffer, Édouard; Bahnini, Amine; Koskas, Fabien

doi:10.1016/s0741-5214(94)70125-3

Cited by 217 publications

(168 citation statements)

References 70 publications

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“…3,11,16 The problem of postsurgical aneurysm formation has also been recognized after bypass grafting for long aortic coarctation and even after subclavian flap aortoplasty. 12,16 Reoperation after previous patch-graft aortoplasty carries a 14% mortality rate and significant morbidity, including paralysis of the nervus recurrens and bleeding complications 3,17 ; similarly, Kieffer et al 18 found that open surgery for thoracic aneurysm in association with aberrant subclavian arteries is associated with a 23.5% mortality rate and a 13% paraplegia rate. Yet, conservative treatment of aneurysm after surgical coarctation repair remains unpredictable and is associated with a 100% rate of rupture within 15 years in the single-center experience of Knyshov et al 3 Our preliminary series demonstrates promising potential of endovascular stent-graft treatment in 6 patients with late aneurysm formation after complex surgical repair of coarctation ( Figure 2, A and B).…”

Section: Discussionmentioning

confidence: 98%

Percutaneous Endovascular Repair of Aneurysm After Previous Coarctation Surgery

et al. 2003

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Background-Formation of aortic aneurysm late after surgical repair of coarctation carries a significant risk of rupture and lethal outcome, and repeat surgery is associated with a 14% in-hospital mortality rate and morbidity from paraplegia, injury to the central nervous system, or from bleeding. The potential of nonsurgical endovascular repair by the use of stent-grafts in lieu of repeat surgery for postcoarctation aneurysm is unknown. Methods and Results-The concept of postsurgical endovascular stent-graft placement was evaluated with respect to feasibility and safety in 6 consecutive patients with late aneurysm formation after coarctation repair. All patients had aneurysm formation late after patch aortoplasty; placement of an elephant trunk during surgical repair of secondary type I dissection preceded formation of a local aneurysm in 2 cases. Patient age was 49Ϯ12 years, ranging from 31 to 68 years. Transluminal placement of customized stent-grafts was successful, with no 30-day or 1-year intervention-related mortality or morbidity. Follow-up survey of 11 to 47 months revealed optimal reconstruction of the thoracic aorta; 1 patient died 11 months after endovascular repair from cancer. Conclusions-Nonsurgical

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Section: Discussionmentioning

confidence: 98%

Percutaneous Endovascular Repair of Aneurysm After Previous Coarctation Surgery

et al. 2003

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“…It is reported that arteria lusoria is more common in females like in our patient and dyspagia is the major symptom of it in adults [9,10]. This condition is called "dysphagia lusoria" [9] which usually present in the fourth or fifth decades [11] and esophageal compression of a rigid trachea is seems to be its cause. The close relationship between the aberrant right subclavian artery, oesophagus, trachea and oculosympathetic pathway is responsible for various presentations seen among these patients.…”

Section: Discussionmentioning

confidence: 54%

A Rare Cause of Horner Syndrome: Arteria Lusoria

Ongun¹,

Tümkaya²,

Değirmenci³

et al. 2017

J Neurol Neurophysiol

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Horner syndrome is a combination of clinical signs, classically of ipsilateral ptosis, pupillary miosis and facial anhydrosis, secondary to the interruption of the oculosympathetic pathway. The causes include tumour infiltration, compression by a lesion such as an aneurysm, iatrogenic causes and traumatic injuries. This paper presents a case of Horner Syndrome due to a rare cause, a congenital anomaly of the aortic arch, arteria lusoria. A 37 year old, female patient referred to our department with a 4 weeks history of ptosis in the right eye. Her medical history was unremarkable. On examination, there was ptosis at her right eyelid and right pupil was myotic. After the tests and examinations, her clinical problem was decided as a well-known condition named "Horner syndrome". Our patient diagnosed as Horner syndrome secondary to aberrant right subclavian artery (arteria lusoria) which is the most common congenital anomaly of the aortic arch. Horner syndrome may be a result of common arterial anomaly like arteria lusoria. Although, there is still not an exact guideline for the diagnostic approach of Horner syndrome and to follow the diagnostic steps according to the patients' condition would be helpful to find the definite underlying pathology of Horner syndrome.

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“…5 ARSA pathologies have traditionally been treated by conventional open repair, which carries considerable mortality (11% to 24%) even in the largest published series. 6 Recently, hybrid repair has been reported. [5][6][7][8] In these hybrid procedures, endovascular vessel occluders combined with carotid-to-subclavian artery bypass grafting/ or fenestrated and aortic stent-graft deployment were successful.…”

Section: Discussionmentioning

confidence: 99%

“…6 Recently, hybrid repair has been reported. [5][6][7][8] In these hybrid procedures, endovascular vessel occluders combined with carotid-to-subclavian artery bypass grafting/ or fenestrated and aortic stent-graft deployment were successful. [7][8][9][10][11] Our case illustrates the applicability of thoracic endovascular aortic repair (TEVAR) with chimney and periscope grafts to address traumatic aortic transection in a patient presenting with ARSA.…”

Section: Discussionmentioning

confidence: 99%

Chimney and Periscope Grafts to Facilitate Endovascular Treatment of Aortic Transection in a Patient With Aberrant Right Subclavian Artery

Glenck

Mayer

Veith

et al. 2014

Journal of Endovascular Therapy

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PURPOSE: To report the use of parallel grafts to extend the proximal landing zone for stentgraft repair of aortic transection involving an aberrant right subclavian artery (ARSA). CASE REPORT: A 28-year-old patient was referred for treatment of traumatic aortic transection with contained rupture at the level of an ARSA. Immediate thoracic endovascular aortic repair (TEVAR) was planned because of hemodynamic instability. To achieve rapid sealing and maintain perfusion to both subclavian arteries, a chimney stent to the left subclavian artery (LSA) and a periscope stent-graft to the ARSA were deployed successfully. After surgical repair of all fractures, the patient was discharged 1 month after the initial injury in good condition. Imaging follow-up at 10 months showed a stable repair, patent parallel grafts, and no complications. CONCLUSION: TEVAR with chimney and periscope grafts proved to be a safe and quick treatment for a patient requiring ARSA repair in acute aortic transection. This technique maintained blood flow to the ARSA and LSA in a totally endovascular approach, which could be very valuable in transection cases where bypass surgery to supra-aortic branches is compromised or deemed challenging due to thoracic wall and/or neck trauma. Parallel grafting can be a valuable tool to address any acute aortic pathology as it can be performed with off-the-shelf devices.

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Aberrant subclavian artery: Surgical treatment in thirty-three adult patients

Cited by 217 publications

References 70 publications

Percutaneous Endovascular Repair of Aneurysm After Previous Coarctation Surgery

Percutaneous Endovascular Repair of Aneurysm After Previous Coarctation Surgery

A Rare Cause of Horner Syndrome: Arteria Lusoria

Chimney and Periscope Grafts to Facilitate Endovascular Treatment of Aortic Transection in a Patient With Aberrant Right Subclavian Artery

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