Open surgical conversion for Type II endoleak following hybrid treatment of a giant aneurysm of aberrant right subclavian artery.

Type II endoleak following hybrid treatment of aneurysms of aberrant subclavian arteries (AARSA) and requiring reintervention is rare. A retroesophageal AARSA with a 70 mm diameter was treated with left and right carotid to subclavian bypasses and thoracic endografting to exclude its ostium. The distal neck was embolized with a vascular plug. At 22 months postoperatively, an angio-computed tomography (CT) scan performed for worsening of dysphagia showed the presence of a Type II endoleak from bronchial arteries with significant sac enlargement. An open surgical repair with thoracotomy, aneurysmorraphy and ligature of the feeding vessels was successfully performed.