Central arch reconstruction and thoracic endovascular aortic repair for complicated acute type B aortic dissection with aberrant right subclavian artery

• Type of Material: Article
• Authors: Andy Dong, Emory University School of Medicine; William Jordan Jr, Emory University; Bradley Leshnower, Emory University
• Language: English
• Date: 2021-12-01
• Publisher: Emory University Libraries
• Publication Version: Final Published Version
• Copyright Statement: © 2021 The Author(s)
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1016/j.xjtc.2021.09.029
• Title of Journal or Parent Work: JTCVS Techniques
• Volume: 10
• Start Page: 178
• End Page: 180
• Keywords: aortic dissection; LSA and ARSA
• Research Categories: Health Sciences, Medicine and Surgery

Abstract

Aberrant right subclavian artery (ARSA) is a rare anatomic variant in which the right subclavian artery originates distal to the left subclavian artery (LSA) and crosses the midline in a retroesophageal course before assuming its right subclavicular position. Patients with acute type B aortic dissection (ATBAD) and ARSA pose a unique challenge due to the absence of an appropriate proximal landing zone for thoracic endovascular aortic repair (TEVAR) without covering both subclavian arteries. In this case series, 2 different hybrid techniques of central 4-vessel arch reconstruction with TEVAR are described to treat 4 patients with complicated ATBAD and ARSA.