Transposition of an anomalous left vertebral artery followed by endovascular treatment of descending thoracic aortic aneurysm using a branched endoprosthesis

The anomalous origin of the left vertebral artery from the aorta is the second most common anatomical alteration of the aortic arch. We present a case of a patient with a descending thoracic aortic aneurysm and an anomalous origin of a dominant left vertebral artery. The artery was treated by transposition to the left common carotid artery via a cervical approach, followed by endovascular correction of the thoracic aortic aneurysm using a subclavian branched thoracic endoprosthesis. The patient had a good postoperative recovery with complete occlusion of the aneurysm and patency of the carotid-vertebral shunt and left subclavian artery.