Endovascular management of blunt aortic injury with an associated aberrant right subclavian artery: a report of three cases

Thoracic Endovascular Repair of Blunt Thoracic Aortic Injury in the Setting of an Aberrant Right Subclavian Artery

Blunt thoracic aortic injury (BTAI) in a patient with an aberrant right subclavian artery (ARSA) presents unique challenges for patient management and aortic repair. Specific considerations include the need to treat coincidental ARSA, subclavian revascularization, and ARSA exclusion. Despite the rise of endovascular repair as the primary modality for aortic repair for BTAI, reports of this technique in the setting of ARSA are limited. Here we describe 3 patients with ARSA who underwent TEVAR for BTAI, and discuss critical management and technical issues in these patients.

Aberrant right subclavian artery in blunt aortic injury: implication for treatment and review of the literature

Blunt aortic injury (BAI) involving an aberrant right subclavian artery (ARSA) is uncommon. The presence of an ARSA entails several treatment issues, in particular regarding the risk of perioperative posterior cerebral stroke. We report the case of a man with an ARSA who suffered from BAI. An initial conservative treatment with delayed open repair was chosen. A review of the published literature with discussion of the case is presented. The presence of an ARSA in patients with BAI can be considered a poor anatomy for endovascular repair, and suitable patients may benefit from delayed open repair.