Endovascular Management of Traumatic Aortic Arch Pseudoaneurysm With Concomitant Left Subclavian Artery Occlusion and Dissection: A Multidisciplinary Case Report.

Blunt thoracic aortic injury (BTAI) with concurrent subclavian artery dissection poses complex challenges. This case highlights the role of multidisciplinary endovascular strategies in managing anatomically hostile injuries. We present a case of a 22-year-old male who presented with BTAI (grade 3 aortic arch pseudoaneurysm) and left subclavian artery (LSA) dissection/occlusion after a three-meter fall. Thoracic endovascular aortic repair (TEVAR) with a Medtronic Valiant™ Captivia™ system thoracic stent graft and LSA stenting using a Fluency™ Plus endovascular stent graft was performed. Postoperative imaging confirmed pseudoaneurysm exclusion and restored LSA flow. Multidisciplinary endovascular repair effectively addresses complex aortic and subclavian injuries. Ultra-short proximal landing zones (<2 mm) require precise stent deployment and hybrid revascularization. This case underscores the feasibility of endovascular repair in anatomically hostile trauma settings and highlights technical strategies that can guide management of similar complex injuries in young patients.