title: Anomalous right subclavian artery and coarctation-related aneurysm repaired with bilateral subclavian-to-carotid transposition and exclusion stent-grafting.
abstract: BACKGROUND
  Aortic arch anomalies are common; however, the presence of concomitant pathology may present a complex management problem.
  
  
  METHODS
  A 42 year old lady with anomalous right subclavian artery was found to have recurrent coarctation of the aorta and an aneurysm related to the previous repair. Management of the aneurysm was complicated by the proximity of subclavian artery origins. Bilateral subclavian-to-carotid transposition was undertaken to preserve antegrade vertebral artery flow, with subsequent exclusion stent-grafting of the aneurysm and coarctation.
  
  
  CONCLUSIONS
  This case illustrates combined surgical and interventional radiological repair to deal with a complex thoracic aortic clinical problem.
authors.affiliation: Department of Vascular Surgery, Bristol Royal Infirmary, Bristol, UK.
authors.forename: O J
authors.initials: OJ
authors.lastname: Denton
authors.forename: J
authors.initials: J
authors.lastname: Bloor
authors.forename: R P
authors.initials: RP
authors.lastname: Martin
authors.forename: A J P
authors.initials: AJ
authors.lastname: Tometzki
authors.forename: M C K
authors.initials: MC
authors.lastname: Hamilton
authors.forename: F C T
authors.initials: FC
authors.lastname: Smith
mesh_terms: D000328:Adult; D001014:Aortic Aneurysm / Q000601:surgery*; D001017:Aortic Coarctation / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation; D002339:Carotid Arteries / Q000601:surgery*; D005260:Female; D006801:Humans; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular; D012008:Recurrence; D015607:Stents; D013348:Subclavian Artery / Q000002:abnormalities / Q000601:surgery*; D014656:Vascular Surgical Procedures / Q000379:methods*