Hybrid Treatment of Arteria Lusoria: A Single Center Algerian Experience

摘要

Aberrant or retro esophageal subclavian arteries may develop symptoms or complications deserving treatment. Such treatment necessitates revascularization of the involved subclavian artery which may be achieved using cervical transposition or bypass along with repair of the distal aortic arch. The advent of endovascular techniques has eased this latter part of treatment. We herein report three cases treated in our department, all male, whose average age is 54 years with as risk factors: smoking, hypertension and dyslipidemia. The discovery of the aberrant subclavian artery was fortuitous, diagnosed on angioscanner during the dissection aneurysm assessment of the thoracoabdominal aorta in 02 patients and one patient for acute thoracic pain. Our patients benefited from hybrid surgery with thoracic stent placement associated with supra-aortic trunk transposition in one patient and carotid and a carotid to axillary bypasses in the second patient, while the third patient benefited exclusive endovascular treatment by placing a Multilayer Flow Modulator Stent. The postoperative evolution was good in all patients, except for one case is found in the control CT scan a type II endoleak, well tolerated by the patient, which will be taken in a second time for a complementary gesture. Our early experience is encouraging using the hybrid approach among three consecutive cases with aneurysmal or dissecting complications of right aberrant subclavian arteries using cervical transposition or bypass along with endovascular aortic repair.