Aneurysm of the left subclavian artery (LSA) in association with coarctation of the aorta (CoAo) is a rare phenomenon, especially in the younger population. A 19-year-old male patient was admitted for lower extremity varices and diagnosed to have severe CoAo and a 45-mm LSA aneurysm after digital subtraction angiography following detection of non-palpable lower extremity pulses on physical examination. Corrective surgery was performed from a left posterolateral thoracotomy through the 4th intercostal space, and a discrete ring-like coarctation tissue was observed in the aorta just below the level of the LSA orifce. Complete excision of the coarctation tissue was followed by aortoplasty with a Dacron patch. Additionally, the subclavian aneurysm was completely excised and a 10-mm Dacron tube graft interposition was performed. Prompt diagnosis and surgical treatment in particularly hypertensive patients precludes significant mortality and morbidity following a possible rupture
