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## Background: A 63year old female was referred to our department with a pulsatile left supra clavicular tumor for further diagnostic and treatment. Medical history included Marfan syndrom, replacement of the aortic valve and the ascending aorta well as open thoracoabdominal aortic replacement. ## Materials and methods: Contrast enhanced Computed Tomography (CT) revealed a giant aneurysm of the proximal and middle left subclavian artery with a maximum diameter of 5.5cm. Due to the proximal extent of the aneurysm open surgical repair would have required a re-re sternotomy approach which was considered technically very high risk. Likewise complete endovascular exclosure was deemed uncertain due to the large size and proximal extent of the aneurysm without an adequate proximal landing zone. We opted therefore for an alternative indirect hybrid approach combining a thoracic aortic stent graft (TEVAR) covering the aortic origin left subclavian artery and left carotid-subclavian bypass as well as transposition of the left vertebral artery into the left common carotid artery for aneurysm exclusion. First a 28x40mm Relay Pro aortic stent graft (Terumo Aortic, UK) was implanted in the dista

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Publisher

Walter de Gruyter GmbH

Published

2023

Language

EN

Field

Medicine (Health Sciences)