Evolution in the Management of Aberrant Subclavian Arteries and Related Kommerell Diverticulum

Multidetector Computed Tomography for Congenital Anomalies of the Aortic Arch: Vascular Rings

“…60,61 Hybrid repair techniques are also being used, such as percutaneous aortic stent placement, percutaneous diverticulum closure, and carotid artery bypass to the right subclavian artery. 59,62 Multidetector computed tomography 10,11,14,15,63 permits the diagnosis and identification of the origin and course of the artery, the degree of compression produced, and the presence of an aortic aneurysm, these are important data for surgery and obviate the need for angiography.…”

A Case of Tandem Plug Embolization for an Aberrant Right Subclavian Artery during Debranching Thoracic Endovascular Aortic Repair

“…Although this was not directly demonstrated in the present case and is not supported by previously published studies, we consider that it is feasible. van Bogerijen et al 2) reported 12 cases of aberrant subclavian artery occlusion during debranching TEVAR with bypass grafting, which was the largest endovascular series ever reported. In their cases, occlusion was accomplished by a vascular plug in seven patients, three of whom developed endoleak that did not require re-intervention.…”

Off-pump Kommerell's diverticulum resection and descending aorta replacement

“…Other methods to provide lower‐body perfusion include left heart (atrio‐femoral) bypass (LHB) or passive aortic shunts such as the Gott shunt; however, flows with these types of shunt are quite variable and very difficult to assess intraoperatively. Thoracic endovascular aortic repair (TEVAR) and various types of hybrid endovascular repair for KD have been reported, but may not be possible in all patients, particularly in those who do not have adequate landing zones for fixation of a stent‐graft . In addition, sealing off the aneurysm with an endovascular stent graft may result in an increased incidence of endoleaks.…”

“…Thoracic endovascular aortic repair (TEVAR) and various types of hybrid endovascular repair for KD have been reported, but may not be possible in all patients, particularly in those who do not have adequate landing zones for fixation of a stent-graft. 5 In addition, sealing off the aneurysm with an endovascular stent graft may result in an increased incidence of endoleaks.…”