Contemporary outcomes after treatment of aberrant subclavian artery and Kommerell's diverticulum

Bath, Jonathan; D’Oria, Mario; Rogers, Richard T.; Colglazier, Jill J.; Braet, Drew J.; Coleman, Dawn M.; Scali, Salvatore T.; Back, Martin R.; Magee, Gregory A.; Plotkin, Anastasia; Dueppers, Philip; Zimmermann, Alexander; Afifi, Rana O.; Khan, Samina; Zarkowsky, Devin S.; Dyba, Gregory; Soult, Michael C.; Mani, Kevin; Wanhainen, Anders; Setacci, Carlo; Lenti, Massimo; Kabbani, Loay; Weaver, Mitchelle R.; Bissacco, Daniele; Trimarchi, Santi; Stoecker, Jordan B.; Wang, Grace J.; Szeberin, Zoltán; Pomozi, Enikő; Moffatt, Clare; Gelabert, Hugh A.; Tish, Shahed; Hoel, Andrew W.; Cortolillo, Nicholas S.; Spangler, Emily L.; Passman, Marc A.; Caridi, Giovanni De; Benedetto, Filippo; Wei, Zhou; Abuhakmeh, Yousef; Newton, Daniel H.; Liu, Christopher M.; Tinelli, Giovanni; Tshomba, Yamume; Katoh, Airi; Siada, Sammy; Khashram, Manar; Gormley, Sinead; Mullins, John R.; Schmittling, Zachary C.; Maldonado, Thomas S.; Politano, Amani D.; Rynio, Paweł; Kazimierczak, Arkadiusz; Gombert, Alexander; Jalaie, Houman; Spath, Paolo; Gallitto, Enrico; Czerny, Martin; Berger, Tim; Stilo, Francesco; Montelione, Nunzio; Mezzetto, Luca; Veraldi, Gian Franco; Lepidi, Sandro; Lawrence, Peter F.; Woo, Karen

doi:10.1016/j.jvs.2023.01.014

Cited by 12 publications

(14 citation statements)

References 29 publications

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“…Histological analyses of resected KD have demonstrated a high prevalence of cystic medial necrosis. 5 Recognition of this finding explains the aneurysmal degeneration of any remaining remnant of the KD left behind following surgical resection. Covering the origin of the KD from the Aorta by TEVAR therefore should be an integral part of the treatment.…”

Section: Discussionmentioning

confidence: 99%

“…Several authors have reported comparable outcomes with similar complication rates over the intermediate term when reporting the results of open repair vs hybrid repair. [3][4][5] In the case described above, the right common carotid artery to subclavian artery transposition was completed through a small neck incision. (Figure 4) The Carotid artery to Axillary artery bypass using an 8-millimeter externally supported PTFE graft was not required.…”

Section: Discussionmentioning

confidence: 99%

“…Several authors have reported comparable outcomes with similar complication rates over the intermediate term when reporting the results of open repair vs hybrid repair. 3-5…”

Section: Discussionmentioning

confidence: 99%

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A Novel Hybrid Approach to Management of KD: Role of Robotic Surgery

Mukherjee,

Singh,

Weyant

et al. 2023

Vasc Endovascular Surg

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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A Novel Hybrid Approach to Management of KD: Role of Robotic Surgery

Mukherjee,

Singh,

Weyant

et al. 2023

Vasc Endovascular Surg

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“…Moreover, ASA/KD can be repaired in asymptomatic patients with excellent outcomes, young and healthy patients might be better suited for open surgical approaches over endovascular/hybrid techniques, given the lower early mortality and reintervention rates. 9 We present a series of patients in a single center with incidental ARSA finding depicted on a CT scan and the natural history of this anomaly along with the morphological changes over time.…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Aberrant Right Subclavian Artery: Demographics, Morphological Features and Follow up CT Scans Dynamics

Shehab,

Kosykh,

Wolf

et al. 2023

Vasc Endovascular Surg

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Introduction: Aberrant right subclavian artery (ARSA) is the most common of the aortic arch anomalies, occurring in .5% to 1% of the population. There is no standardized follow up protocol, especially in the asymptomatic cases. The purpose of the present study was to evaluate the natural history of ARSA and the role of serial CT scans. Methods: This is a single-center retrospective study of patients with ARSA depicted on chest computed tomography (CT) scans between February 2013 and July 2022. Data were collected from their medical records. Measurements of the aorta at different segments including the aortic diameter at the orifice of ARSA, and ARSA at ostium followed by 1 cm intervals were collected, as well as for follow-up CT scans. Results: 65 patients were diagnosed with ARSA, 70.8% of whom were women. The average age for the cohort was 58.569 ± 16.99 years. The median follow up time was 4 years (range 0-10 years), KM estimated survival after ARSA diagnosis at 1 and 5 years as 97% and 93%, respectively. Nineteen patients had a second CT scan and were included in the morphological CT dynamic analysis, on average of 29 ± 27 months apart (range 7-108). The mean ARSA diameter at origin was larger in the second scan 16.91 ± 4.31 mm compared to the initial scan 16.31 ± 4.96 mm, ( P = .04).The mean aortic arch diameter in the first and second CT were 28.54 ± 4.24 and 29.64 ± 5.14 ( P = .10), respectively. All other measurements did not disclose any significant enlargement over time. Conclusions: Our cohort demonstrate a benign natural history of ARSA with slow growth rates. However, due to our small sample size we can’t draw a clinically sound recommendation on the need for imaging follow up, and further larger cohort with longer follow up interval are required.

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