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Abstract
A case of successful endovascular repair of right aortic arch with the aberrant left subclavian artery (ALSA) arising from Kommerell’s diverticulum (KD). Our strategy consisted of coil embolization for the orifice of the ALSA, put the bypass between left common carotid artery and left subclavian artery and exclusion of KD by stent graft insertion. Enhanced computed tomography scan 36 months after the operation showed successful exclusion of KD, patency of the bypass graft, and no evidence of endoleak. Endovascular repair can be a safe and effective treatment for aortic disease with challenging anatomy in the midterm, avoiding the need for a complex open surgery procedure. It is very rare in this successful case with midterm result we presented.
Highlights
Surgery for Kommerell’s diverticulum is said to be difficult due to typical anatomical findings
A focal dilatation was noted at the aberrant left subclavian artery (ALSA) origin, indicating Kommerell’s diverticulum (KD)
Operation was started at the spine position. At first he underwent the extra-anatomical bypass between the ALSA and the left common carotid artery using 6 mm ePTFE graft
Summary
Surgery for Kommerell’s diverticulum is said to be difficult due to typical anatomical findings. We had successful surgical case using stentgraft insertion for the Kommerell’s diverticulum with the left aberrant subclavian artery in right aortic arch patient with 36-month follow up. Due to the size of the KD and the potential for rupture, the patient elected to undergo Debranching TEVAR with a left common carotid artery - the ALSA bypass using 6 mm ePTFE graft. Operation was started at the spine position At first he underwent the extra-anatomical bypass between the ALSA and the left common carotid artery using 6 mm ePTFE graft. The patient had no postoperative complications and was discharged 7 days later He remained asymptomatic with symmetric upper extremity blood pressures during 36-month follow-up. J Vasc Med Surg 3: 203. doi:10.4172/2329-6925.1000203
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