Surgical treatment of aneurysms of the intrathoracic segment of the subclavian artery.

From June 1969 to May 1986, 16 patients underwent 17 operations to treat 18 aneurysms of the intrathoracic segment of the subclavian artery. Surgical treatment in 12 cases involved Dacron tube graft replacement; in the remainder, patch graft angioplasty or exclusion with and without extra-anatomic revascularization were utilized. Twelve patients required simultaneous graft replacement of aortic aneurysms. Five procedures were performed through a median sternotomy and 12 through a left posterior lateral thoracotomy. Deep hypothermia and circulatory arrest was used on three occasions. All but one patient were early survivors, and there were no related cerebrovascular accidents. There were five late deaths unrelated to operative treatment. Surgical treatment of aneurysms of the intrathoracic segment of the subclavian artery is both well tolerated and durable.