Surgical Reconstruction for Intrathoracic Aneurysm Originating from Proximal Part of the Right Subclavian Artery

Abstract

Subclavian artery aneurysms are comparatively rare in peripheral aneurysms. We experienced a case of intrathoracic aneurysm originating from the proximal part of the right subclavian artery. A 78 year-old man was referred to our hospital with the diagnosis of a right subclavian artery aneurysm. Enhanced computed tomography demonstrated an intrathoracic aneurysm, originating from the right subclavian artery just proximal of its origin. Through a median sternotomy and supra-infraclavicular incision, we reconstructed the brachiocephalic and right common carotid arteries and bypassed to the distal part of the right subclavian artery by using a T-shaped vascular graft and the aneurysm was excluded.

Operative repair of right intrathoracic subclavian artery aneurysms in patients with genetic arteriopathy

“…Surgical resection of SCAAs and an interposition bypass graft is the standard treatment 2 , 3 , 5 , 13 with some cases of necessitating ligation without reconstructions. 2 , 5 When the aneurysm neck is short, a median sternotomy with a right supraclavicular extension is required for exposure, whereas a focal aneurysm with a longer proximal neck can be reached via a supraclavicular approach alone.…”

Claviculectomy for exposure and redo repair of expanding, recurrent right subclavian aneurysm

“…Although most SAA are identified as incidental imaging findings, local compression may also cause symptoms, 3,8 including: brachial plexopathy, Horner syndrome, hoarseness, dysphagia, hemoptysis, chest pain, effort fatigue, and thrombosis or embolization. 5,9,10 Diameter is not correlated with risk of SAA rupture and ruptures of the proximal and middle segment SAAs are most commonly reported 2,3,10,11 . Emergent repair is associated with a 13% mortality rate versus 3% for elective repair.…”

“…Subclavian artery aneurysms (SAAs) are uncommon and surgical repair is usually performed using median sternotomy, posterolateral thoracotomy, or supraclavicular exposure [1][2][3] .…”

Open repair of a proximal left subclavian artery mycotic aneurysm with median claviculectomy

“… 1 , 2 Although patients are often poor surgical candidates, more invasive methods of exposure such as thoracotomy or median sternotomy are still used in the treatment of SAMAs. 2 , 3 , 4 , 5 , 6 An anatomic exposure using claviculectomy has remained underused and rather controversial. We report a median claviculectomy method of exposure for the successful repair of a 1.9-cm left SAMA distal to the left vertebral artery with a subclavian artery to axillary artery bypass using the right great saphenous vein.…”