H Jalaie1, J Grommes2, A Sailer3, A Greiner2, M Binnebösel4, J Kalder2, G W Schurink5, M J Jacobs6. 1. European Vascular Centre Aachen-Maastricht, University Hospital of the RWTH Aachen, Aachen, Germany. Electronic address: hjalaie@ukaachen.de. 2. European Vascular Centre Aachen-Maastricht, University Hospital of the RWTH Aachen, Aachen, Germany. 3. Department of Diagnostic and Interventional Radiology, Maastricht University Medical Centre, Maastricht, The Netherlands. 4. European Vascular Centre Aachen-Maastricht, University Hospital of the RWTH Aachen, Aachen, Germany; Department of General, Visceral and Transplantation Surgery, University Hospital of the RWTH Aachen, Aachen, Germany. 5. European Vascular Centre Aachen-Maastricht, Maastricht University Medical Centre, Maastricht, The Netherlands. 6. European Vascular Centre Aachen-Maastricht, University Hospital of the RWTH Aachen, Aachen, Germany; European Vascular Centre Aachen-Maastricht, Maastricht University Medical Centre, Maastricht, The Netherlands. Electronic address: mjacobs@ukaachen.de.
Abstract
OBJECTIVE: The aim of this study is to present experience with 10 patients with symptomatic aberrant subclavian artery (ASA) and aneurysm of ASA who underwent surgical treatment. METHODS: From 2008 to 2011 10 patients with symptomatic aberrant subclavian artery (mean age 60 years [range 24-90 years]) were studied. Symptoms were dysphagia (n = 7), dyspnea (n = 4), acute chest pain (n = 1), respiratory distress syndrome (n = 1), superior cava syndrome, and shock (n = 1). Six patients had aneurysm formation of the ASA (mean diameter of 7.1 cm [range 3.0-12.4 cm]; rupture [n = 1], dissection [n = 1]). All data were analyzed retrospectively. RESULTS: Treatment was performed as a hybrid procedure in eight patients. This included thoracic endoluminal graft exclusion with revascularization of the ASA, a pure endovascular procedure with two occluders in one patient, and an open procedure in one patient with ligation of the aberrant artery through a thoracotomy. Three patients died during the early postoperative period owing to pulmonary complications. All three suffered from a symptomatic aneurysm, and two were treated as an emergency procedure. Median follow-up was 20 months (range 12-49 months). CONCLUSION: A symptomatic ASA and its associated aneurysmal formation should be excluded after diagnosis. In most cases, a hybrid procedure consisting of thoracic endografting and revascularization of the ASA is feasible.
OBJECTIVE: The aim of this study is to present experience with 10 patients with symptomatic aberrant subclavian artery (ASA) and aneurysm of ASA who underwent surgical treatment. METHODS: From 2008 to 2011 10 patients with symptomatic aberrant subclavian artery (mean age 60 years [range 24-90 years]) were studied. Symptoms were dysphagia (n = 7), dyspnea (n = 4), acute chest pain (n = 1), respiratory distress syndrome (n = 1), superior cava syndrome, and shock (n = 1). Six patients had aneurysm formation of the ASA (mean diameter of 7.1 cm [range 3.0-12.4 cm]; rupture [n = 1], dissection [n = 1]). All data were analyzed retrospectively. RESULTS: Treatment was performed as a hybrid procedure in eight patients. This included thoracic endoluminal graft exclusion with revascularization of the ASA, a pure endovascular procedure with two occluders in one patient, and an open procedure in one patient with ligation of the aberrant artery through a thoracotomy. Three patients died during the early postoperative period owing to pulmonary complications. All three suffered from a symptomatic aneurysm, and two were treated as an emergency procedure. Median follow-up was 20 months (range 12-49 months). CONCLUSION: A symptomatic ASA and its associated aneurysmal formation should be excluded after diagnosis. In most cases, a hybrid procedure consisting of thoracic endografting and revascularization of the ASA is feasible.
Authors: Tulio Fabiano de Oliveira Leite; Lucas Alves Sarmento Pires; Rafael Cisne; Marcio Antonio Babinski; Carlos Alberto Araujo Chagas Journal: J Vasc Bras Date: 2017 Oct-Dec