Reverse blood flow treatment for aneurysmal subarachnoid hemorrhage due to interrupted aortic arch with aberrant...

Interrupted aortic arch (IAA) is a rare congenital defect involving complete discontinuity between the aortic arch and descending aorta. Aberrant right subclavian artery (ARSA) is a common variant, occasionally causing vascular complications. Intracranial aneurysm (IA) rupture leads to subarachnoid hemorrhage (SAH), a life-threatening event. The coexistence of IAA, ARSA, and IA is extremely rare and poses significant diagnostic and therapeutic challenges.

This report describes a young patient with type B IAA and ARSA, who also presented with multiple IA. The patient was admitted due to SAH. The extreme vessel angle of the right subclavian artery to the aorta and the reversal of blood flow in bilateral vertebral arteries made cerebral angiography and therapy difficult.

In young patients with IA, underlying vascular anomalies affecting hemodynamics should be carefully evaluated. IAA with ARSA poses challenges for vascular access but does not preclude safe and effective endovascular treatment. Comprehensive assessment and individualized planning are essential for favorable long-term outcomes.