• Shuxiong Ge, Zhongyou Xu, and Jinlin Yan.
• Department of Vascular Surgery, People's Hospital affiliated to Ningbo University, Ningbo, Zhejiang.
• Medicine (Baltimore). 2024 Mar 8; 103 (10): e37410e37410.

RationaleAcute type B aortic dissection (ABAD) is a fatal cardiovascular disease with high morbidity and mortality. Isolated left vertebral artery (ILVA) is a rare aortic arch mutation originating from the aortic arch. The simultaneous occurrence of both increases the complexity and difficulty of thoracic endovascular aortic repair. However, there have been few reports on the recommendation of thoracic endovascular aortic repair treatment strategies for aortic dissection patients concomitant ILVA with insufficient landing zone. Here, we report a case of ABAD combined with ILVA treated with hybrid surgery of left vertebral artery transposition alliance with Scallop and in vivo fenestration endograft.Patient ConcernsA 38-year-old middle-aged man was transferred to our vascular department with persistent pain in his lower abdomen for 8 hours.DiagnosesPreoperative computed tomography angiogram of the thoracic and abdominal aorta diagnosed with ABAD accompanied with ILVA.InterventionsHybrid surgery of left vertebral artery transposition alliance with Scallop and in situ fenestration endograft for revascularization of ILVA, left subclavian artery, and left common carotid artery.OutcomesThe hybridization operation was successfully completed. There were no complications of cerebral and spinal cord ischemia after operation. Computed tomography angiogram examination indicated no internal leakage existed in the stent and patency of the arch vessels and the transposed left vertebral artery follow-up 3 months after surgery.LessonsThis study gave us experience in the treatment of aortic dissection with left vertebral artery variation and suggested that left vertebral artery transposition combined with scallop and in vivo fenestration stent is safe and effective.Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.

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