Total endovascular repair of aberrant left subclavian artery with Kommerell's diverticulum using a customized branched device.

Silveira, Pierre Galvagni; Franklin, Rafael Narciso; Cunha, Josué Rafael Ferreira; Neves, Thais Torres; Nascimento, Gilberto Galego; Bortoluzzi, Cristiano Torres · J Vasc Surg · 2013

case_report · Level V

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Abstract

We describe a case of Kommerell's diverticulum involving the distal portion of a right-sided aortic arch and the origin of an aberrant left subclavian artery (LSA). The patient underwent a total endovascular repair with the use of a modified Valiant endograft (Medtronic, Minneapolis, Minn) to which a branch was attached to keep LSA patency. Postoperative computed tomography showed complete exclusion of the lesion, without endoleaks. The use of "customized off-label" devices to treat special conditions was feasible in this case, keeping patency of the LSA without risk of arm claudication or the requirement for a complementary surgical bypass.

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