Endovascular repair of a type B aortic dissection with transposition of a coexistent aberrant subclavian (lusorian) artery.
OBJECTIVE
To report the endovascular treatment of a relatively uncommon entity: an aortic type B dissection combined with an aberrant subclavian artery (SA).


METHODS
A 59-year-old patient was admitted with chest pain and interscapular back pain. A transesophageal ultrasound and magnetic resonance angiography revealed a type B aortic dissection originating at the level of an aberrant SA orifice. After failure of medical therapy, the dissection was treated by transluminal implantation of an Excluder stent-graft covering the entry site of the dissection at the aberrant SA orifice. Prior to the endovascular procedure, a transposition of the aberrant SA to the right carotid artery was performed through a supraclavicular approach. The patient remains asymptomatic at 19 months after the endovascular repair.


CONCLUSIONS
Endovascular repair of a type B aortic dissection in the presence of a lusorian artery appears to be a feasible, safe, and less invasive alternative to conventional surgery. The need for concurrent transposition of the SA remains to be determined.
Vos
A W Floris
AW
Department of Vascular Surgery, Vrije Universiteit Medical Center, Amsterdam, The Netherlands.
Wisselink
Willem
W
Rijbroek
Abraham
A
Avontuur
Jurgen A
JA
Manoliu
Radu A
RA
Rauwerda
Jan A
JA
D000784:Aortic Dissection / Q000000981:diagnostic imaging / Q000601:surgery*; D001014:Aortic Aneurysm / Q000000981:diagnostic imaging / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation; D005260:Female; D006801:Humans; D018810:Magnetic Resonance Angiography; D008875:Middle Aged; D011859:Radiography; D015607:Stents; D013348:Subclavian Artery / Q000002:abnormalities* / Q000601:surgery