Treatment of Kommerell’s diverticulum in rare aberrant aortic arch anatomy

Abstract

A Kommerell’s diverticulum (KD) is a saccular aneurysmal outpouching at the origin of an aberrant subclavian artery. Due to a lack of data in the literature, there are no standardized guidelines for management of KD, and the diverse presentation of associated aberrant anatomy complicates evaluating the best modality of treatment. We present a 74-year-old woman who had a uniquely aberrant aortic arch with an aberrant retroesophageal right subclavian artery associated with a KD and a saccular aneurysm off the left subclavian artery who was treated via a hybrid approach, demonstrating the feasibility of this treatment modality in a patient with unique aberrant arch anatomy.

KEY POINTS

• Kommerell’s diverticulum (KD) is a rare congenital anomaly, and whether one should treat KD is controversial.

• Especially unique aberrant arch anatomy presents a technical challenge for treatment amidst the concomitant lack of consensus on intervention for KD treatment.

• In this case report, successful repair of KD with unique aberrant arch anatomy was done in a hybrid staged fashion with extrathoracic revascularization followed by thoracic endovascular aortic repair.

Keywords:

• Aberrant arch
• aberrant subclavian artery
• endovascular
• hybrid
• kommerell’s diverticulum

Disclosure statement/Funding

The authors report no funding or conflicts of interest. The patient provided consent for the publication of case details and imaging studies.