Open Repair of a Right Subclavian Artery Aneurysm with Vertebral Artery Reimplantation: Companion Questions

Watch in 4K: Open Repair of a Right Subclavian Artery Aneurysm with Vertebral Artery Reimplantation https://youtu.be/ZYr4cCvZJ8Y This video presents the challenging open repair of a large right subclavian artery aneurysm with vertebral artery reimplantation. It is designed for surgical trainees, vascular fellows, and medical students seeking a detailed, narrated overview of complex supra-aortic trunk reconstruction. A 64-year-old woman presented with a pulsatile supraclavicular mass. Imaging confirmed a complex aneurysm of the right subclavian artery. The repair required a combined approach: median sternotomy, infraclavicular, and supraclavicular exposures to ensure safe proximal and distal control.The proximal subclavian artery and vertebral artery stumps were combined into a single common cuff, which was anastomosed end-to-end to an interposition graft. The graft was then tunneled distally to the axillary artery. The procedure is narrated by Roy Saade with additional comments by surgeon Carlos Saadeh to highlight decision-making and technical details at each step. Key events showcased and explained: 1- Indications for subclavian artery aneurysm repair 2- Surgical options for repair (Open vs. Endovascular) 3- Segmental anatomy of the subclavian artery and its surgical implications4- Exposure and control of the innominate artery and its proximal branches via sternotomy 5- Infraclavicular exposure of the axillary artery 6- Supraclavicular exposure of the subclavian artery 7- Creation of a submuscular tunnel linking mediastinal and supraclavicular dissections 8- Common ostium reconstruction of the proximal subclavian and vertebral arteries9- Distal anastomosis between the graft and axillary artery All footage is original, multi-angled, and UHD, supplemented by select textbook and internet images for clarity. More cases coming soon. Watch in UHD with captions for the best learning experience. All images used in this video are included under Fair Use for educational purposes only. We would also like to thank Dr Jessika Tawil for her support during the creation of this video. Timeline: 00:18 Introduction 03:23 Exposure of the Innominate Artery and Its Branches 07:06 Infraclavicular Exposure of the Axillary Artery 10:51 Supraclavicular Exposure of the Subclavian Aneurysm 15:02 Opening of the Aneurysm Sac 18:20 Proximal Anastomosis (Graft to Proximal Subclavian Artery + Vertebral Artery Reimplantation) 26:38 Distal Anastomosis (Graft to Axillary Artery) Medical Disclaimer:This video is intended strictly for educational and informational purposes. It is not a substitute for formal surgical training or professional medical advice. The techniques demonstrated reflect the personal practice of the operating team and may vary from those used in other institutions or by other surgeons. Viewers are advised to evaluate the content in the context of current standards, evidence-based practice, and institutional protocols. This video is not intended to encourage or enable untrained individuals to perform surgical procedures. Surgery should only be performed by licensed professionals with appropriate credentials, experience, and supervision. All patients featured have given informed written consent for the filming and public sharing of their procedures, with full respect for their dignity and privacy. Identifiable details have been omitted or altered where appropriate. The creators of this content assume no responsibility for outcomes resulting from the use or interpretation of the techniques shown herein. This video is not affiliated with, nor does it represent the views of, any hospital, university, or medical organization unless explicitly stated. We have no disclosures. Contact: We welcome your questions in the comments section below and will endeavor to respond. For more in-depth inquiries, collaboration proposals, or academic requests, please email: roysaade@clampandflow.com You can also DM me on X (Twitter). Social Media Follow us for more surgical content, previews, and behind-the-scenes clips: X (Twitter): https://x.com/ClampandFlow