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The coexistence of an aberrant right subclavian artery (ARSA) with a common carotid trunk (CCT) represents an extremely rare anomaly of the aortic arch. We have only found a couple of cases describing this anomaly in the literature [1, 2]. As with atherosclerotic aneurysm of the normal aortic arch, aneurysmal dilatation of the origin of ARSA requires early definitive intervention for the risk of rupture and dissection. Many open surgical techniques for the treatment of this condition have been reported [3], and recently endovascular stent graft procedures have been proposed as an alternative and less invasive treatment to surgery [4].

A 78-year-old man who is diabetic with severe chronic obstructive pulmonary disease was referred to our institution for dysphagia and a persistent cough that has recently developed. Chest computed tomographic scan revealed an aneurysmal dilatation of the origin of a retroesophageal …