{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T16:50:38Z","timestamp":1780419038920,"version":"3.54.1"},"reference-count":14,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,7,5]],"date-time":"2022-07-05T00:00:00Z","timestamp":1656979200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100002947","name":"Basic and Clinical Cooperative Research Promotion Plan of Anhui Medical University","doi-asserted-by":"publisher","award":["2020xkjT029"],"award-info":[{"award-number":["2020xkjT029"]}],"id":[{"id":"10.13039\/501100002947","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Giant true subclavian artery aneurysms (SAAs) (&amp;gt;5\u2005cm) are rare. Technical and anatomical considerations complicate the endovascular treatment of SAAs and pose some challenges. Here, we present a giant right SAA that was successfully excluded using stent grafts with the pull-through technique after two interventional steps and discuss the pull-through technique details as well as the lessons to be learned from this case.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A 50-year-old man presented at our department complaining of dyspnea and hoarseness. Computed tomography angiography (CTA) showed a giant right SAA with partial intraluminal thrombus and severe angulated aneurysm necks originating from the proximal right subclavian artery, approximately 70\u2009\u00d7\u200971\u2005mm in size.<\/jats:p><\/jats:sec><jats:sec><jats:title>Outcomes<\/jats:title><jats:p>An 8\u2009\u00d7\u2009100-mm Gore Viabahn was selected to exclude the SAA. A decision was made to stabilize the wire tension using the pull-through technique. Final angiography showed that the SAA was essentially excluded, and slight endoleak was observed. At 6 months, imaging showed that the aneurysm was not obviously shrinking, there was still an endoleak and stent graft dislodgement was observed. Angiography confirmed a type Ia endoleak, which was managed by the placement of a 10\u2009\u00d7\u200950-mm Gore Viabahn, again with the assistance of the pull-through technique. At the 25-month follow-up, CTA showed that the SAA was satisfactorily excluded, with no endoleak, and the SAA was reduced in size.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Endovascular treatment of SAAs is a safe, reliable and minimally invasive approach. The pull-through technique may improve wire tension and device stabilization. Additionally, size selection and positioning should be reappraised under a severely angulated aneurysm neck.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fsurg.2022.939818","type":"journal-article","created":{"date-parts":[[2022,7,5]],"date-time":"2022-07-05T05:44:15Z","timestamp":1656999855000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":6,"title":["Endovascular Repair for Giant Right Subclavian Artery Aneurysm With Gore Viabahn and Pull-Through Procedure: A Case Report"],"prefix":"10.3389","volume":"9","author":[{"given":"Binshan","family":"Zha","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhiyong","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huan","family":"Ou-yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,7,5]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1016\/j.ejvs.2010.03.011","article-title":"Changing profiles of diagnostic and treatment options in subclavian artery aneurysms","volume":"40","author":"Vierhout","year":"2010","journal-title":"Eur J Vasc Endovasc Surg"},{"key":"B2","doi-asserted-by":"publisher","first-page":"445","DOI":"10.1093\/ejcts\/ezs408","article-title":"Giant aneurysm of the proximal left subclavian artery","volume":"43","author":"Komoda","year":"2013","journal-title":"Eur J Cardiothorac Surg"},{"key":"B3","doi-asserted-by":"publisher","first-page":"128","DOI":"10.1055\/s-0034-1372245","article-title":"Giant subclavian artery aneurysm","volume":"25","author":"Counts","year":"2016","journal-title":"Int J Angiol"},{"key":"B4","doi-asserted-by":"publisher","first-page":"291","DOI":"10.1016\/j.avsg.2017.08.013","article-title":"Stenting of subclavian artery true and false aneurysms: a systematic review","volume":"47","author":"Maskanakis","year":"2018","journal-title":"Ann Vasc Surg"},{"key":"B5","doi-asserted-by":"publisher","first-page":"290.e1","DOI":"10.1016\/j.avsg.2016.02.041","article-title":"Endovascular repair of a right subclavian artery aneurysm with coil embolization and stent graft: case report and literature review","volume":"36","author":"Li","year":"2016","journal-title":"Ann Vasc Surg"},{"key":"B6","doi-asserted-by":"publisher","first-page":"36","DOI":"10.1016\/j.pcad.2013.06.001","article-title":"Peripheral arterial aneurysms: open or endovascular surgery?","volume":"56","author":"Mohan","year":"2013","journal-title":"Prog Cardiovasc Dis"},{"key":"B7","doi-asserted-by":"publisher","first-page":"307","DOI":"10.1007\/s00392-016-1059-9","article-title":"Transcatheter closure of a giant right subclavian artery aneurysm","volume":"106","author":"Lu","year":"2017","journal-title":"Clin Res Cardiol"},{"key":"B8","doi-asserted-by":"publisher","first-page":"237","DOI":"10.1055\/s-0032-1328967","article-title":"Embolization of an aberrant right subclavian artery aneurysm with amplatzer vascular plug without bypass","volume":"21","author":"Leong","year":"2012","journal-title":"Int J Angiol"},{"key":"B9","doi-asserted-by":"publisher","first-page":"139","DOI":"10.1016\/j.asjsur.2019.04.012","article-title":"Single center experience in the management of a case series of subclavian artery aneurysms","volume":"43","author":"Davidovic","year":"2020","journal-title":"Asian J Surg"},{"key":"B10","doi-asserted-by":"publisher","first-page":"670","DOI":"10.1177\/0267659117720988","article-title":"Endovascular repair of subclavian artery aneurysms: results from a single-center experience","volume":"32","author":"Gao","year":"2017","journal-title":"Perfusion"},{"key":"B11","doi-asserted-by":"publisher","first-page":"167","DOI":"10.1177\/159101991301900204","article-title":"A simplified pull-through angioplasty technique without a snare device. 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