scholarly journals Combined endovascular and surgical (hybrid) repair of type B aortic dissection with aneurysmal degeneration involving Kommerell's diverticulum and aberrant right subclavian artery

2015 ◽  
Vol 61 (3) ◽  
pp. 800 ◽  
Author(s):  
William J. Quinones-Baldrich
Keyword(s):  
Aortic Dissection ◽  
Subclavian Artery ◽  
Aberrant Right Subclavian Artery ◽  
Type B ◽  
Type B Aortic Dissection ◽  
Kommerell’S Diverticulum ◽  
Hybrid Repair

Hybrid Repair With Endovascular Debranching of the Aberrant Right Subclavian Artery for Complicated Type B Aortic Dissection in Patients With Kommerell’s Diverticulum

2021 ◽  
pp. 152660282199671
Author(s):  
Yu-Chen Chien ◽  
Nai-Kuan Chou ◽  
I-Hui Wu
Keyword(s):  
Aortic Dissection ◽  
Subclavian Artery ◽  
Bypass Graft ◽  
Covered Stent ◽  
Aberrant Right Subclavian Artery ◽  
Type B ◽  
Type B Aortic Dissection ◽  
Landing Zone ◽  
Kommerell’S Diverticulum ◽  
Hybrid Repair

Purpose: Aberrant right subclavian artery (ARSA) associated with Kommerell’s diverticulum (KD) is a common congenital arch anomaly. It can be complicated by type B aortic dissection (TBAD) or aneurysmal formation at its ostium. Recently, hybrid repair with thoracic endovascular aortic repair (TEVAR) has appeared to be more favorable. Due to the normal anatomic proximity of the ARSA to the left subclavian artery (LSA) orifice in KD, coverage of the bilateral subclavian arteries (SCAs) to obtain an adequate proximal landing zone (PLZ) is usually required, and double cervicotomy for SCA revascularization potentially increases the risk of complications. Technique: This technique was demonstrated on a 50-year-old man presenting with progressive aneurysmal formation of KD with ARSA after chronic TBAD. A 3-step technique, namely left cervical debranching with a left common carotid artery to LSA bypass graft, TEVAR, and an LSA-to-ARSA endovascular debranching with a self-expanding covered stent by a through-and-through wire from the right brachial artery to the bypass graft, was performed in a 1-stage repair to cover the primary tear of TBAD and preserve the bilateral SCAs. The postoperative course was uneventful. Conclusion: This technique can prevent complications from double cervicotomy and achieve an adequate PLZ with preservation of the bilateral SCAs for TEVAR.

scholarly journals Aberrant Right Subclavian Artery and Stanford Type B Aortic Dissection

2020 ◽  
Vol 8 (8) ◽  
pp. 247-249
Author(s):  
Yuvraj Chowdhury ◽  
Shakil A. Shaikh ◽  
Ali Salman ◽  
Jonathan D. Marmur ◽  
Isabel. M. McFarlane
Keyword(s):  
Aortic Dissection ◽  
Subclavian Artery ◽  
Aberrant Right Subclavian Artery ◽  
Type B ◽  
Type B Aortic Dissection ◽  
Stanford Type B

scholarly journals Repair of a type B aortic dissection with a re-vascularization of the aberrant right subclavian artery in an adult patient

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Mahmoud Yousef Ibrahim Abuharb ◽  
Bian Xiao Ming ◽  
He Jian
Keyword(s):  
Aortic Dissection ◽  
Subclavian Artery ◽  
Incidental Finding ◽  
Aberrant Right Subclavian Artery ◽  
Uneventful Recovery ◽  
Type B ◽  
Type B Aortic Dissection ◽  
Case Presentation ◽  
Therapeutic Implications ◽  
Aortic Branch

Abstract Background An aberrant right subclavian artery which arises from the proximal descending aorta may result in aortic dissection. The dissection may occur at either the site of the primary intimal tear or from an aortic branch. These conditions may lead to blood flow limitation and possible aneurysmal degeneration in the future. Case presentation We described the clinical presentation and management of a 54-year old patient diagnosed with a rare case of an aberrant right subclavian artery with Stanford Type B aortic dissection. A hybrid surgical approach was successfully performed and the patient had an uneventful recovery. Conclusion Even though aortic dissection is often an incidental finding, this case highlighted that in rare situations, it can be associated with an aberrant right subclavian artery. It is important to disseminate this association as it has profound diagnostic and therapeutic implications in safeguarding the clinical outcomes of patients with such condition.

scholarly journals Treatment with Aortic Stent Graft Placement for Stanford B-Type Aortic Dissection in a Patient with an Aberrant Right Subclavian Artery

2015 ◽  
Vol 2015 ◽  
pp. 1-5
Author(s):  
Yohei Kawatani ◽  
Yujiro Hayashi ◽  
Yujiro Ito ◽  
Hirotsugu Kurobe ◽  
Yoshitsugu Nakamura ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Stent Graft ◽  
Subclavian Artery ◽  
Distal Portion ◽  
Aberrant Right Subclavian Artery ◽  
Type B ◽  
Type B Aortic Dissection ◽  
Aortic Stent Graft ◽  
The Right ◽  
Stanford Type B

A 71-year-old man visited our hospital with the chief complaint of back pain and was diagnosed with acute aortic dissection (Debakey type III, Stanford type B). He was found to have a variant branching pattern in which the right subclavian artery was the fourth branch of the aorta. We performed conservative management for uncomplicated Stanford type B aortic dissection, and the patient was discharged. An ulcer-like projection (ULP) was discovered during outpatient follow-up. Complicated type B aortic dissection was suspected, and we performed thoracic endovascular aortic repair (TEVAR). The aim of operative treatment was ULP closure; thus we placed two stent grafts in the descending aorta from the distal portion of the right subclavian artery. The patient was released without complications on postoperative day 5. Deliberate sizing and examination of placement location were necessary when placing the stent graft, but operative techniques allowed the procedure to be safely completed.

Endovascular Aortic Repair With Castor Single-Branched Stent-Graft in Treatment of Acute Type B Aortic Syndrome and Aberrant Right Subclavian Artery

2021 ◽  
pp. 153857442110056
Author(s):  
Xinyan Pang ◽  
Shi Qiu ◽  
Chen Wang ◽  
Kai Liu ◽  
Xin Zhao ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Stent Graft ◽  
Subclavian Artery ◽  
False Lumen ◽  
Endovascular Aortic Repair ◽  
Aberrant Right Subclavian Artery ◽  
Acute Type ◽  
Type B ◽  
Type B Aortic Dissection ◽  
Aortic Repair

Objective: In this retrospective study, we presented the results of Castor single-branched stent-graft in a small series of patients with acute type B aortic syndrome and aberrant right subclavian artery (ARSA). Methods: Between January 2019 and November 2019, 5 patients were diagnosed with acute type B aortic syndrome and ARSA (4 patients with intramural hematoma and ARSA, 1 patient with type B aortic dissection and ARSA). All the patients underwent thoracic endovascular aortic repair (TEVAR) using Castor single-branched stent-graft. In-hospital and 3-month outcomes were collected. Results: The mean operative time was 116 ± 20.43 minutes (range 90-145). All the TEVAR procedures were successfully performed without conversion to open surgery (100% success rate). All the ARSAs of the 5 patients were revascularized in situ by Castor single-branched stent-grafts. No deaths and complications were observed in the 3-month follow-up. The maximal diameters of diseased aortas in the 4 patients with IMH decreased 3 months after TEVAR. The false lumen in the graft-covered segment was completely thrombosed in the patient with type B aortic dissection. Conclusions: Castor single-branched stent-graft may be a good choice in treatment of acute type B aortic syndrome and aberrant right subclavian artery.

scholarly journals Outcomes of hybrid procedure for type B aortic dissection with an aberrant right subclavian artery

2018 ◽  
Vol 67 (3) ◽  
pp. 704-711 ◽  
Author(s):  
Huanyu Ding ◽  
Songyuan Luo ◽  
Yuan Liu ◽  
Wenhui Huang ◽  
Minchun Jiang ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Subclavian Artery ◽  
Hybrid Procedure ◽  
Aberrant Right Subclavian Artery ◽  
Type B ◽  
Type B Aortic Dissection

scholarly journals Three Rare Structural Anomalies: Right Aberrant Subclavian Artery, Kommerell’s Diverticulum, and Isolated Left Vertebral Artery All Associated with Type B Aortic Dissection

2019 ◽  
Vol 2019 ◽  
pp. 1-4
Author(s):  
Yasser Farag Elghoneimy ◽  
Medhat Reda Nashy ◽  
Ahmed Elsayed Mahmoud ◽  
Asayel Ali Alruwaili ◽  
Assayl Rabea Alotaibi
Keyword(s):  
Aortic Dissection ◽  
Vertebral Artery ◽  
Subclavian Artery ◽  
Left Vertebral Artery ◽  
Type B ◽  
Type B Aortic Dissection ◽  
Aberrant Subclavian Artery ◽  
First Case ◽  
Kommerell’S Diverticulum ◽  
Structural Anomalies

Introduction and Background. Right aberrant subclavian artery accounts for 0.5-1.8% of the population as the most frequently encountered aortic arch anomaly, while the prevalence of an isolated left vertebral artery ranges from 3 to 8%. Despite the low prevalence and the asymptomatic presentation of these structural anomalies, the development of cardiovascular complications and aneurysmal formation could happen as in Kommerell’s diverticulum in a complicated right aberrant subclavian artery, which can undergo aneurysmal degeneration and dissection. Depending on the severity and the degree of the symptoms, the management of the patient can be determined. Case Presentation. A 51-year-old male hypertensive Pakistani patient was admitted complaining of chest and back pain; a CT of the aorta was done and showed type B aortic dissection associated with a right aberrant subclavian artery with an isolated left vertebral artery. A thoracic endovascular aneurysmal repair was done, and the patient improved afterward. Conclusion. The prevalence of these structural anomalies, the right aberrant subclavian artery, Kommerell’s diverticulum, and isolated left vertebral artery with type B aortic dissection, is uncommon. Therefore, the earlier the diagnosis, the better the treatment. This is the first case report explaining the occurrence of these vascular anomalies together in Saudi Arabia.

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