title: Innovative use of an Amplatzer septal occluder for occlusion of a large right subclavian artery aneurysm and reconstruction of the posterior aortic arch wall.
abstract: OBJECTIVE
  To highlight the efficacy of the Amplatzer septal occluder in endovascular exclusion of an aberrant right subclavian artery aneurysm and reconstruction of the posterior aortic arch wall for subsequent endovascular placement of a thoracic graft.
  
  
  METHODS
  A 73-year-old lady with prohibitive surgical risk was found to have a 35 × 39 mm aberrant right subclavian artery aneurysm as well as a 7.6 cm wide thoracic aortic aneurysm. Repair of both defects was performed endoluminally with the patient awake. An Amplatzer septal occluder was used for successful exclusion of the subclavian artery. Additionally, the device enabled reconstruction of the posterior aortic arch wall, thereby providing a landing zone for subsequent placement of a custom-made thoracic endograft.
  
  
  CONCLUSIONS
  The Amplatzer septal occluder provides an innovative endovascular alternative for complex, large subclavian artery aneurysms.
authors.affiliation: Department of Vascular Surgery, Royal Perth Hospital, Perth, Western Australia, Australia. aruledward@gmail.com
authors.forename: Arul
authors.initials: A
authors.lastname: Suthananthan
authors.forename: Kishore
authors.initials: K
authors.lastname: Sieunarine
mesh_terms: D000368:Aged; D000783:Aneurysm / Q000000981:diagnostic imaging / Q000628:therapy*; D017545:Aortic Aneurysm, Thoracic / Q000000981:diagnostic imaging / Q000601:surgery*; D001027:Aortography / Q000379:methods; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000295:instrumentation*; D057510:Endovascular Procedures / Q000295:instrumentation*; D005260:Female; D006801:Humans; D011474:Prosthesis Design; D055989:Septal Occluder Device; D013348:Subclavian Artery / Q000000981:diagnostic imaging / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome