Hybrid endovascular treatment of aneurysm degeneration in a rare right-aortic arch anomaly with Kommerell diverticulum.
We present a hybrid endovascular approach to a 6.5-cm aneurysm of the right-sided aortic arch with an aberrant left subclavian artery arising from a Kommerell diverticulum, connected to the left pulmonary artery through the ligamentum arteriosum. The two-step procedure consisted of a bilateral carotid-subclavian bypass, followed by an ascending aorta-bicarotid bypass and completed by an endovascular exclusion of the aneurysms by covering the whole aortic arch and its branches. The patient had no complications and is asymptomatic 21 months after surgery. Hybrid procedures may be helpful in complex aortic arch pathologies, reducing complications of challenging open surgery.
Frigatti
Paolo
P
Division of Vascular and Endovascular Surgery, Department of Cardiac, Thoracic and Vascular Sciences, University of Padova Medical School, Padova, Italy.
Grego
Franco
F
Deriu
Giovanni P
GP
Lepidi
Sandro
S
D000015:Abnormalities, Multiple / Q000000981:diagnostic imaging / Q000628:therapy*; D017130:Angioplasty / Q000379:methods*; D001013:Aorta, Thoracic / Q000002:abnormalities*; D017545:Aortic Aneurysm, Thoracic / Q000000981:diagnostic imaging / Q000628:therapy*; D019917:Blood Vessel Prosthesis Implantation; D003131:Combined Modality Therapy; D018450:Disease Progression; D004240:Diverticulum / Q000151:congenital* / Q000000981:diagnostic imaging / Q000601:surgery; D005500:Follow-Up Studies; D006801:Humans; D018810:Magnetic Resonance Angiography / Q000379:methods; D008297:Male; D008875:Middle Aged; D035583:Rare Diseases; D018570:Risk Assessment; D012720:Severity of Illness Index; D013348:Subclavian Artery / Q000002:abnormalities*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome