Aneurysm of the Aberrant Right Subclavian Artery: Surgical and Hybrid Repair of Two Cases in a Single Center

Results of aberrant right subclavian artery aneurysm repair

“…Nevertheless, to date, safety and efficacy of these new approaches remain unproven because aberrant subclavian artery repairs, despite the increased number of recent publications, have been sporadically explored and reported in multiple case reports and in a few small single-center series. [1][2][3][4][5][6][7][8] In this setting, the lack of long-term results is another reason for concern.…”

“…[1][2][3][4] The renewed interest was largely prompted by the increased detection of aneurysm of aberrant right subclavian artery (AARSA), often as an unexpected finding during preoperative imaging workup for the endovascular approach to arch diseases, and the development of new technical strategies for treatment. Management strategies have been evolving, including currently different hybrid endovascular interventions.…”

Tratamiento híbrido de arteria subclavia derecha aberrante

“…Se cree que el origen de esta malformación ocurre por involución del IV arco aórtico derecho con persistencia de la séptima arteria intersegmental derecha 4 . Estas arterias aberrantes tienden a dilatarse y pueden complicarse con fenómenos tromboembólicos de la extremidad superior derecha o con ruptura; la que se asocia a altas tasas de mortalidad; incluso mayor a 50% 5 . Además puede asociarse a otras alteraciones del desarrollo del arco aórtico o de la aorta descendente; como coartación aórtica 6 .…”

“…Estas no se han podido relacionar con algún tamaño bajo el cual sería razonable sólo observar; por lo que incluso se ha planteado el tratamiento de cualquier arteria subclavia aberrante dilatada, independiente de su diá-metro 5 . Los tratamientos descritos tradicionalmente son la cirugía mediante toracotomía o esternotomía, pudiendo requerir circulación extracorpórea, que tienen elevadas tasas de morbimortalidad de hasta 25% 7 .…”

Is total debranching a safe procedure for extensive aortic-arch disease? A single experience of 27 cases

“…Indications for the 27 patients included: 18 transverse arch aneurysms (10 saccular and six fusiform), four acute type B dissections associated with distal aneurysm, two subclavian artery aneurysms (one aberrant right subclavian artery aneurysm (ARSAA) [1] and one left subclavian artery (LSA) aneurysm), and three with penetrating aortic ulcers of the aortic arch. The primary end point of this retrospective study was to evaluate the clinical and technical success rate of HP.…”