Large Right True Subclavian Artery Aneurysm Treated With Hybrid Surgery

Introduction: Subclavian artery (SCA) aneurysms are rare, accounting for less than 1% of peripheral aneurysms. Repair is indicated due to the risk of complications. Methods: The electronic medical records in our institution were reviewed and the case of a patient with large right SCA is presented. Results: An 80 year-old female, with complex medical history, presented with a large right SCA aneurysm. She was deemed high risk for open repair and underwent innominate and common carotid artery stent graft placement, embolization of the sac, and carotid to axillary artery bypass. Her clinical course was complicated by an atheroembolic multiterritorial stroke, and she was found to be clopidogrel resistant. She was discharged to a rehabilitation facility and was recovering well at 3 months after surgery. Conclusion: Detailed and careful pre-operative planning, as well as familiarity with the different surgical approaches is necessary for the best outcomes.