A 62-year-old female patient with a known aberrant right subclavian artery (ARSA) and previous endovascular repair of Stanford type-B aortic dissection presented for follow-up. CT revealed a contained rupture of the proximal descending aorta with a maximum diameter of 80 mm involving the aortic arch and the origin of the ARSA. Combined debranching of the supra-aortic vessels via median sternotomy and endovascular obliteration of the thoracic aortic aneurysm was performed. The aberrant ARSA was ligated. Postoperative imaging showed excellent results without endoleak. The postoperative course confirmed tolerance of ARSA ligation. A hybrid approach to the proximal descending aorta is favorable even in cases of aberrant right subclavian artery. A team approach and appropriate planning is essential for success.
The English full-text version is available at SpringerLink (under“Suppplemental”).