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- Jan Bosma, Alexander D Montauban van Swijndregt, and Anco C Vahl.
- Department of Vascular Surgery, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands. janbosma@yahoo.com
- J. Endovasc. Ther. 2010 Dec 1; 17 (6): 762-6.
PurposeTo report a patient with a ruptured diverticulum of Kommerell and to discuss treatment options and complications.Case ReportAn 82-year-old woman with no prior medical history was diagnosed with a ruptured aneurysmal proximal aberrant right subclavian artery (diverticulum of Kommerell). She was treated with a carotid-subclavian bypass, a thoracic aortic stent-graft covering both subclavian orifices, and a vascular plug in the proximal right subclavian artery. After an initially uneventful recovery, the patient developed delayed ischemic esophageal ulcerations and subsequent perforation at 6 weeks postoperatively, leading to mediastinitis and stent-graft infection.ConclusionA hybrid approach may be of value in cases of ruptured diverticulum of Kommerell. However, despite the anticipated reduction in perioperative mortality, this technique still yields a considerable risk of postoperative complications and mortality.
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