Hybrid Treatment of Arteria Lusoria: A Single Center Algerian Experience
International Journal of Cardiovascular and Thoracic Surgery
Volume 4, Issue 6, November 2018, Pages: 43-48
Received: Aug. 16, 2018; Accepted: Nov. 5, 2018; Published: Mar. 2, 2019
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Souad Benallal, Faculty of Medicine, University “Djilali Liabes”, Sidi Bel Abbes, Algeria
Mohamed Nadjib Bouayed, Department of Vascular Surgery, College of Medical Sciences of ORAN, Oran, Algeria
Fabien Koskas, Department of Vascular Surgery, University Hospital "Pitie Salpetrière", Paris, France
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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.
Arteria Lusoria, Subclavian Artery Retro-Esophageal, Aberrant Subclavian Artery, Kommerell Diverticulum, Aortic Endograft
To cite this article
Souad Benallal, Mohamed Nadjib Bouayed, Fabien Koskas, Hybrid Treatment of Arteria Lusoria: A Single Center Algerian Experience, International Journal of Cardiovascular and Thoracic Surgery. Vol. 4, No. 6, 2018, pp. 43-48. doi: 10.11648/j.ijcts.20180406.11
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P. O. Myers et al. / Annales de Cardiologie et d’Angéiologie 59 (2010) 147–154.
Edwards JE. Vascular rings and slings. In Fetal, Neonatal, and Infant Cardiac disease, Moller JH, Neal WA (eds). Norwalk, CT : Appleton & Lange: 1990; 745-754.
Van Son JA, Konstantinov IE, Kommerell BF. Kommerell’s diverticulum. Tex Heart Inst J 2002;29 (2): 109–12.
Epstein DA, Debord JR. Abnormalities associated with aberrant right subclavian arteries – a case report. Vasc Endovascular Surg 2002;36 (4): 297–303.
PROYE C. A., CARNAILLE B. M., GOROPOULOS A. Non recurrent and recurrent inferior laryngeal nerve: a surgical pitfall in cervical exploration, Am J Surg, 1991, vol. 162, n° 5, 495-496.
SALOMONOWITZ E., EDWARDS J. E., HUNTER D. W., CASTANEDA-ZUNIGA W. R. et al. The three types of aortic diverticula, AJR Am J Roentgenol, 1984, vol. 142, n° 4, 673-679.
Freed K, Low VH. The aberrant subclavian artery. Am J Roentgenol 1997; 168 (2): 481–4.
G S. Oderich, Rochester. Evidence of use of multilayer flow modulator stents in treatment of thoracoabdominal aortic aneurysms and dissections. Journal of Vascular Surgery April 2017.; 65: 935-7- 0741-5214.
AKERS D. L., JR., FOWL R. J., PLETTNER J., KEMPCZINSKI R. F. Complications of anomalous origin of the right subclavian artery: case report and review of the literature, Ann Vasc Surg, 1991, vol. 5, n° 4, 385-388.
CHEW F. S., PANICEK D. M., HEITZMAN E. R. Late discovery of a posttraumatic right aortic arch aneurysm, AJR Am J Roentgenol, 1985, vol. 145, n° 5, 1001-1002.
DE BAKEY M. E., COOLEY D. A., CREECH O., JR. Surgical considerations of dissecting aneurysm of the aorta, Ann Surg, 1955, vol. 142, n° 4, 586-610;discussion, 611-582.
OTA T., OKADA K., TAKANASHI S., YAMAMOTO S., OKITA Y. Surgical treatment for Kommerell's diverticulum, J Thorac Cardiovasc Surg, 2006, vol. 131, n° 3, 574-578.
AUSTIN E. H., WOLFE W. G. Aneurysm of aberrant subclavian artery with a review of the literature, J Vasc Surg, 1985, vol. 2, n° 4, 571-577.
DAVIDIAN M., KEE S. T., KATO N., SEMBA C. P., RAZAVI M. K. et al. Aneurysm of an aberrant right subclavian artery: treatment with PTFE covered stentgraft, J Vasc Surg, 1998, vol. 28, n° 2,335-339.
FISHER R. G., WHIGHAM C. J., TRINH C. Diverticula of Kommerell and aberrant subclavian arteries complicated by aneurysms, Cardiovasc Intervent Radiol, 2005, vol. 28, n° 5, 553-560.
Schnarkowski P, Weidenmaier W, Von Gumppenberg R. Ruptured aneurysm of an aberrant right subclavian artery: CT and angiographic findings. Eur J Radiol 1992; 15: 138-9.
Hoppe H, Hohenwalter EJ, Kaufman JA, Petersen B. Percutaneous treatment of aberrant right subclavian artery aneurysm with use of the Amplatzer septal occluder. J Vasc Interv Radiol 2006;17 (5): 889–94
Poon FW, Stewart IS. Aneurysm of an aberrant right subclavian artery. Br J Radiol 1988; 61: 249-51.
G Gautier, ORouvière, ARaudrant, CPangaudet DLyonnet, Anévrismes de l'artère sous clavière droite aberrante : bilan tomodensitométrique, Journal de radiologie, Vol 84, N° 11-C1 - novembre 2003, pp. 1767-1770, Doi : JR-11-2003-84-11-C1-0221-0363-101019-ART9. © 2003 Elsevier Masson SAS.
J. P. Laissy et al. Imaging of the normal thoracic aorta, variation and congenital anomalies. 32-210. A-10. EMC RADIOLOGY HEART LUNG 2006 Elsevier Masson SAS.
Marvin E. Morris, Makamson Benjamin, Glenn P. Gardner, W. Kirt Nichols, Rumi Faizer, Columbia, Missouri, USA, Utilisation d’un plug Amplatzer pour traiter une dysphagia lusoria caus_ee par une artere sous-clavi_ere droite aberrante, Ann Vasc Surg 2010; 24: 416.e5-416.e8, DOI: 10.1016/j.acvfr.2010.10.009.
Attmann T, Brandt M, Muller-Hulsbeck S, Cremer J. Two-stage surgical and endovascular treatment of an aneurysmal aberrant right subclavian (Lusoria) artery. Eur J Cardiothorac Surg 2005; 27 (6): 1125–7.
E. Kieffer. Artère Sous-clavière Rétro-œsophagienne. Actualités de chirurgie vasculaire: Chirurgie des troncs supra-aortiques 2003.
Corral JS, Zuniga CG, Sanchez JB, et al. Treatment of aberrant right subclavian artery aneurysm with endovascular exclusion and adjunctive surgical bypass. J Vasc Interv Radiol 2003;14 (6): 789–92.
Schwein A, Georg Y, Ohana M A, Thaveau F, Chakfe N, et al Title: Treatment of aneurysmal aberrant right subclavian artery with triple-barrel stentgraft, Annals of Vascular Surgery (2015), doi: 10.1016/j.avsg.2014.10.035.
He H, Yao K, Nie WP, Wang Z, Liang Q, Shu C, Endovascular treatment for acute type B aortic dissection involving a right-sided aortic arch and Kommerell’s diverticulum: A case report and review of the literature, Annals of Vascular Surgery (2015), doi: 10.1016/j.avsg.2014.12.028.
Tanaka K, Yoshitaka H, Chikazawa G, Sakaguchi T, Totsugawa T, Tamura. Hybrid repair of right aortic arch aneurysm with a Kommerell's diverticulum. Asian Cardiovasc Thorac Ann. 2014 Jul; 22(6): 725-7. doi: 10.1177/0218492313481465. Epub 2013 Sep 4. PMID: 24887812.
Thèse de Fanette JEANNON, ARTERIA LUSORIA, Etude morpho densitométrique de 150 cas, Applications cliniques, Faculté De Médecine De Nancy, 2011.
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