Treatment of aberrant right subclavian artery aneurysm with endovascular exclusion and adjunctive surgical bypass.

Aberrant right subclavian arteries occur in as much as 2% of the population. Aneurysms in this vessel are rare but exhibit a marked propensity toward rupture; therefore, early elective treatment is indicated. Transluminally placed stent-grafts offer an alternative approach to the standard surgical treatment. This type of procedure is less invasive, with less attendant risk than operative repair. Because there was no proximal neck between the aneurysm and Kommerell diverticulum in the case described herein, it was decided to perform endovascular exclusion of the aneurysm by inserting an endoprosthesis to occlude the aortic exit of the aneurysm, combined with distal ligation. A bilateral carotid/subclavian bypass was also created to preserve the function of both subclavian arteries.