Modified Total Arch Debranching TEVAR with Aberrant Left Vertebral Artery.

Total arch debranching and thoracic endovascular repair of an aortic arch aneurysm with a left aberrant vertebral artery are rare procedures. A small artery is difficult to reconstruct and anastomose in a narrow thoracic space with a large aneurysm. We describe an 85-year-old man with a fusiform aortic arch aneurysm and left aberrant vertebral artery who underwent a hybrid procedure with reconstruction of the left aberrant vertebral artery at a surgical site in the neck. Postoperative computed tomography images confirmed exclusion of the aneurysm and patency of all arch vessels, including the left vertebral artery.