Endovascular management of traumatic rupture of aberrant right subclavian artery

Acute bleeding from intrathoracic or mediastinal arteries due to blunt thoracic trauma is a life-threatening condition. Although rare, individuals with an abnormal vascular anatomy can be encountered among patients suffering from a traumatic vascular injury. Aberrant right subclavian artery (ARSA) is the most common congenital anomaly of the aortic arch. A 51-year-old male patient was referred to our hospital following a motorcycle accident. The patient had a ruptured ARSA and mediastinal hematoma. Due to concomitant intracranial hemorrhage, open surgery was considered to have a high risk. Therefore, we decided to treat the patient with endovascular intervention, and successfully repaired the ruptured segment by stent-graft implantation. Aberrant right subclavian artery inherently courses a long distance and it is vulnerable to damage in case of a thoracic trauma. We suggest that endovascular interventions and hybrid procedures may be primarily preferred in traumatic ARSA injuries, and they constitute an alternative to open surgery.