Hybrid zone 1 repair of a giant post-traumatic intrathoracic left subclavian artery pseudoaneurysm.

Subclavian artery pseudoaneurysms are rare and may present decades after blunt trauma. We report the case of a 38-year-old man presenting 22 years after clavicular fracture with a giant intrathoracic pseudoaneurysm of the proximal left subclavian artery, with the vertebral artery arising immediately distal to the lesion. Due to the limited proximal landing zone and short carotid-subclavian distance, a one-stage hybrid repair was performed, consisting of carotid-carotid-subclavian bypass and zone 1 thoracic endovascular aortic repair. The procedure achieved complete exclusion with preserved cerebral and upper limb perfusion. At 5 years, the patient remains asymptomatic without endoleak or graft-related complications.