Tandem use of Amplatzer vascular plugs is a feasible and effective technique to completely eliminate residual endoleakage during aberrant right subclavian artery embolization in debranching TEVAR.
May require multiple plugs for complete aberrant right subclavian embolization in debranching TEVAR; leaves open optimal occlusion strategies.
Aberrant right subclavian artery embolization is problematic in debranching thoracic endovascular aortic repair, because concomitant bypass grafting to the right upper arm may hinder complete embolization. We report a case of a thoracic aortic aneurysm with aberrant right subclavian artery successfully treated with debranching thoracic endovascular aortic repair and bypass grafting. Although endoleakage was found from aberrant right subclavian artery after single use of Amplatzer vascular plug, additional deployment of Amplatzer vascular plug II completely eliminated residual endoleakage. This simple technique is useful for the aberrant right subclavian artery embolization in debranching thoracic endovascular aortic repair.
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Onzuka et al. (2016) studied this question.
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