Clinical Report: Combined Approach for Managing Subclavian-Axillary Aneurysms

Background

Syndromic hereditary thoracic aortic diseases (sHTAD) are associated with a high risk of aneurysms and dissections, particularly in patients with Loeys-Dietz syndrome (LDS). Surgical management is complicated by vessel wall fragility and the need for multiple interventions. There is a growing interest in hybrid surgical techniques that may reduce the physiological burden of extensive open surgeries. Aneurysms in other vascular beds are also observed in patients with sHTAD, particularly those with LDS.

Data Highlights

No numerical data or trial data provided in the article.

Key Findings

• Hybrid techniques combining endovascular and open surgical approaches are being explored for managing aneurysms in sHTAD patients.
• Two cases of LDS patients were treated using a hybrid approach for subclavian-axillary artery aneurysms.
• In Case 1, a 42-year-old male underwent a two-staged repair involving a Frozen Elephant Trunk (FET) and subsequent endovascular repair.
• In Case 2, a 63-year-old female with extensive aneurysmal disease received a hybrid repair after multiple previous surgeries.
• The hybrid approach allows for targeted exclusion of aneurysmal segments while minimizing the risks associated with open surgery.

Clinical Implications

Further studies are needed to evaluate the long-term outcomes and safety of hybrid surgical techniques for managing complex aneurysms in patients with LDS.

Related Resources & Content

1. European Society for Vascular Surgery (ESVS) 2026 Clinical Practice Guidelines on the Management of Descending Thoracic and Thoraco-Abdominal Aortic Diseases – Editor's Choice
2. Surgical Techniques for Clipping Anterior Communicating Aneurysms: My Approach
3. Transorbital Technique for Treating Anterior Communicating Artery Aneurysms: A Step-by-Step Guide
4. Pediatric Cardiology — Proceedings of the PICS-AICS Virtual Symposium Held from September 10 to 12, 2020
5. Pediatric Cardiology — Outcomes of Single-Stage Surgical Intervention for Aortic Arch Obstruction in Patients with Transposition of the Great Arteries: A Decadal Review
6. European Society for Vascular Surgery (ESVS) 2026 Clinical Practice Guidelines on the Management of Descending Thoracic and Thoraco-Abdominal Aortic Diseases – Editor's Choice - ScienceDirect
7. Management of the left subclavian artery during zone II thoracic endovascular aneurysm repair: a systematic review and network meta-analysis - PubMed