Introduction:
Aneurysmal degeneration of aberrant right subclavian artery (ARSA) carries a relevant risk of rupture. Timely elective treatment is mandatory. Therapeutic options include open surgery repair or hybrid surgical and endovascular repair. Few reports of total endovascular approach repair have been reported.
Presentation of the case:
We report the first case of total endovascular repair of an aneurysmal ARSA using a thoracic aortic endograft with a "periscope" covered stent into the ARSA itself.
Discussion:
The total endovascular approach was considered for patient's age and her poor compliance to the idea of a surgical revascularization of the ARSA, which has to be preserved since the LSA was diseased. The urgent situation did not allow for the use of a custom-made graft, so the idea of a "periscope" covered graft both to preserve the flow of the ARSA and to exclude the aneurysmal lesion seemed to be the best choice.
Conclusion:
The "periscope" technique allowed the urgent treatment of aneurysmal ARSA with good clinical results.