Hybrid treatment for thoracic aortic aneurysm combined with aberrant right subclavian artery

An aberrant right subclavian artery (ARSA) is the most common vascular abnormality of the aortic arch and is associated with development of aneurysms in 3-8% of these anomalies. In this case report, we describe an 84-year-old man with a symptomatic ARSA treated with staged hybrid procedure combining surgical replacement of the ascending aorta and bilateral carotid-to-subclavian artery bypass with implantation of a stent graft in the aortic arch and descending aorta. Our case suggests that a less invasive hybrid therapy can be performed successfully for the treatment of ARSA with aneurysmal change in patients at high surgical risk.