Abstract
A brachiocephalic artery aneurysm is rare, with cases of a brachiocephalic artery aneurysm along with a distal arch aneurysm being rarer. Herein, we report a rare case of a brachiocephalic artery aneurysm with a distal arch aneurysm in a 50-year-old man who was treated with two-stage repair surgery. The patient was diagnosed with sigmoid colon carcinoma on computed tomography. The sigmoid colon carcinoma was resected. Because of suspected gastrointestinal bleeding associated with systemic heparinization at the time of aneurysm treatment, open surgery was performed for treating the brachiocephalic aneurysm, and thoracic endovascular aortic repair (TEVAR) was performed for treating the distal arch aneurysm. It is a common policy to perform two-stage repair surgery for treating arch aneurysms, while median sternotomy is performed for treating brachiocephalic artery aneurysms. We clamped the innominate artery by using an external shunt, to avoid cerebral ischemia; the surgery was completed safely. After sigmoid colon carcinoma resection, TEVAR, a non-invasive procedure, was used to avoid extracorporeal circulation, and the distal arch aortic aneurysm was treated with a non-invasive procedure; all the procedures showed good results.
