• Ann Vasc Surg · Jul 2014

    Case Reports

    Endovascular repair of a right-sided thoracic aortic aneurysm with Kommerell diverticulum and aberrant left subclavian artery.

    • Mario Monaco, Stefano Lillo, Agostino La Marca Giordano, Antonio Contaldo, and Vincenzo Schiavone.
    • Department of Vascular Surgery, Pineta Grande Hospital, Castelvolturno (CE), Italy. Electronic address: mariomonaco55@libero.it.
    • Ann Vasc Surg. 2014 Jul 1;28(5):1323.e1-5.

    BackgroundA case of successful total endovascular repair of a right-sided descending thoracic aorta aneurysm (r-DTAA) with Kommerell diverticulum and aberrant left subclavian artery (ALSA) was reported. Few cases of this very rare pathology were reported, mostly describing a hybrid treatment, with only 2 cases of total endovascular repair performed to date.Methods And ResultsOur strategy consisted of endovascular ALSA occlusion, without preventive revascularization, and r-DTAA exclusion by 2 endoprosthesis implanted in a telescopic fashion, first the distal one, to achieve a relative straightening of the arch and support the proximal endoprosthesis, and then the proximal one, close to the right subclavian origin. Completion angiography and 12-month computed tomography scan showed successful exclusion, patency of epiaortic vessels, and absence of endoleak.ConclusionEndovascular repair can be a safe and effective treatment for aortic disease with challenging anatomy, avoiding the need for a complex open surgery procedure.Copyright © 2014 Elsevier Inc. All rights reserved.

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