Chimney Technique for Aortic Dissection Involving an Aberrant Right Subclavian Artery Makoto Samura, MD, Nobuya Zempo, MD, Yoshitaka Ikeda, MD, Yoshikazu.

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Chimney Technique for Aortic Dissection Involving an Aberrant Right Subclavian Artery Makoto Samura, MD, Nobuya Zempo, MD, Yoshitaka Ikeda, MD, Yoshikazu Kaneda, MD, Kazuhiro Suzuki, MD, Hidetoshi Tsuboi, MD, Kimikazu Hamano, MD The Annals of Thoracic Surgery Volume 97, Issue 1, Pages 315-317 (January 2014) DOI: 10.1016/j.athoracsur.2013.05.094 Copyright © 2014 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 (A) Preoperative three-dimensional computed tomograms showing a type B aortic dissection and an aberrant right subclavian artery arising from the aortic arch, distal to the origin of the left subclavian artery (arrow). (B) Radiograph showing the left-sided hemothorax. (C) Computed tomograms showing the ruptured dissection, the entry site (arrow), the true lumen (T), and the false lumen (F). The Annals of Thoracic Surgery 2014 97, 315-317DOI: (10.1016/j.athoracsur.2013.05.094) Copyright © 2014 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 (A) Angiogram obtained just before deployment of the stent-grafts, showing the entry site (dotted arrow) and the proximal edge of the Excluder iliac extender (dashed arrow), positioned adjacent to the proximal edge of the TAG stent-graft (solid arrow). (B) Postoperative three-dimensional computed tomography showing the occlusion of the origin of the ARSA and the absence of endoleaks; the flow to the right subclavian artery was maintained by the adverse flow from the right vertebral artery. (C) Three-dimensional computed tomography obtained at the 3-month follow-up, showing the absence of endoleaks and showing the patent left subclavian artery. The Annals of Thoracic Surgery 2014 97, 315-317DOI: (10.1016/j.athoracsur.2013.05.094) Copyright © 2014 The Society of Thoracic Surgeons Terms and Conditions