Treatment of symptomatic aberrant subclavian arteries.

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.

• Authors: H Jalaie, J Grommes, A Sailer, A Greiner, M Binnebösel, J Kalder, G W Schurink, M J Jacobs
• Journal: European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery (Eur J Vasc Endovasc Surg) Vol. 48 Issue 5 Pg. 521-6 (Nov 2014) ISSN: 1532-2165 [Electronic] England
• PMID: 25150442 (Publication Type: Journal Article)
• Copyright: Copyright © 2014 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.

Topics

• Adult
• Aged
• Aged, 80 and over
• Aneurysm (complications, surgery)
• Aortic Dissection (complications, surgery)
• Aortic Aneurysm, Thoracic (complications, surgery)
• Cardiovascular Abnormalities (complications, surgery)
• Deglutition Disorders (complications, surgery)
• Endovascular Procedures (methods)
• Female
• Humans
• Male
• Middle Aged
• Postoperative Complications (prevention & control)
• Stents
• Subclavian Artery (abnormalities, surgery)
• Treatment Outcome
• Young Adult