[Hybrid Surgery for Right Subclavian Artery Aneurysm]

A 78-year-old man with a history of surgery for rectal cancer three years before underwent hybrid surgery for a 35-mm right subclavian artery aneurysm. First, the vertebral artery was transposed to the common carotid artery to maintain its bloodstream. Second, axillo-common carotid artery ipsilateral bypass was constructed to preserve the carotid-artery flow. Finally, endovascular repair was performed via the axillary artery to exclude the subclavian artery aneurysm. A 13-mm×10-cm GORE VIABAHN and subsequently an upside-down 27-mm×14-cm GORE EXCLUDER Contralateral Leg were placed from the brachiocephalic artery to the subclavian artery distal to the aneurysm with coiling of the internal thoracic artery and ligation of the proximal common carotid artery. No postprocedural neurological complication occurred despite occlusion of the transposed vertebral artery on contrast-enhanced computed tomography (CT). The patient was uneventfully discharged 11 days after the hybrid surgery. Less invasive hybrid surgery may be useful to repair a right subclavian artery aneurysm.