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Technical Strategy in a Patient with Symptomatic Thoracic Aneurysm Near the Origin of the Left Subclavian Artery and Left Internal Thoracic Artery Coronary Graft

Abstract  Thoracic endovascular aortic repair (TEVAR) is a safe and reliable technique utilized in the treatment for aortic aneurysms. However, in up to 40% of patients, devices are typically placed over the left subclavian artery (LSA) origin. In this report, we present a case of a successful TEVAR procedure following the transposition of the LSA with protective carotico‐axillary/carotid bypass in a patient with a patent left internal thoracic artery (LITA)‐left anterior descending (LAD) coronary artery bypass graft and right internal carotid artery (ICA) occlusion. (J Card Surg 2012;27:725‐727)