Supraclavicular transposition of aberrant left vertebral artery for hybrid treatment of aortic arch aneurysm: a case rep
- PDF / 2,254,798 Bytes
- 4 Pages / 595.276 x 790.866 pts Page_size
- 5 Downloads / 154 Views
CASE REPORT
Open Access
Supraclavicular transposition of aberrant left vertebral artery for hybrid treatment of aortic arch aneurysm: a case report Kyo Seon Lee, Gwan Sic Kim, Yochun Jung, In Seok Jeong, Kook Joo Na, Bong Suk Oh, Byung Hee Ahn and Sang Gi Oh*
Abstract Background: Vertebral artery variations are common in thoracic aortic patients. If patients have the aberrant left vertebral artery, the more difficult to determine the treatment modality. Case presentation: We report the case of a 63-year-old man with an aberrant left vertebral artery originating from an aneurysmal aortic arch. The patient underwent a successful hybrid thoracic endovascular aortic repair after aortic arch debranching and transposition of the aberrant left vertebral artery to the left common carotid artery through a supraclavicular incision without sternotomy. Conclusions: The aberrant left vertebral artery originating from the aortic arch can be safely transposed to the left common carotid artery through a supraclavicular approach. Keywords: Aortic arch, Aortic operation, Stents, Case report
Background Although stent-grafts have evolved in recent years, the management of aortic arch disease remains to be difficult due to the arch vessels. In about 40% of patients undergoing thoracic endovascular aortic repair (TEVAR), the left subclavian artery (LSA) must be intentionally covered in order to obtain an adequate proximal landing zone and achieve stable sealing [1]. However, if patients have the aberrant left vertebral artery, the more difficult to determine the treatment modality. We describe a case treated with a novel hybrid TEVAR technique without sternotomy. Case presentation A 65-year-old man presenting with chest pain and back pain was transferred to our hospital for further evaluation of aortic arch aneurysm on chest radiograph. He had been taking anti-hypertensive for 2 years. On admission, his heart rate was 76 beats per minute in sinus rhythm and blood pressure was 110/70 mmHg. * Correspondence: [email protected] Department of Thoracic and Cardiovascular Surgery, Chonnam National University Hospital, Chonnam National University School of Medicine, 42, Jebong-ro, Dong-gu, Gwangju 15772, South Korea
Chest computed tomography (CT) was performed and revealed a thrombosed aneurysm of the aortic arch. Maximal diameter was 62 mm. The aneurysm extended from immediately distal to the left common carotid artery (LCA) up to the distal aortic arch, and the aberrant left vertebral artery originated from just proximal aortic arch segment with aneurysmal change. Neck and brain CT was performed to evaluate the neck vessels and the intracranial arteries. There was no occlusive lesion of the neck vessels, including both vertebral arteries, and the continuity of the circle of Willis was intact. However, there was hypoplasia on the left vertebral artery at T1 level (Fig. 1). The patient underwent arch vessel debranching surgery through a supraclavicular approach. The left supraclavicular incision was performed and the LSA and the LCA wer
Data Loading...
