Hybrid management of proximal right subclavian artery aneurysms

Surgical repair of proximal right subclavian artery aneurysms can be difficult. They typically require a combined mediastinal exposure to control the innominate and right common carotid arteries and a supra- or infraclavicular exposure for distal control, with either a segmental resection and bypass or a bifurcated reconstruction. In this report, we present four cases utilizing a single-stage, hybrid technique combining an endovascular stent graft and an extra-anatomical bypass to repair proximal right subdavian artery aneurysms without the need for mediastinal exposure or extensive surgical reconstruction. There were no deaths and two minor neurologic events. (J Vase Surg 2011;53:528-30.)