Right-sided aortic arch with an aberrant left subclavian artery is a rare aortic arch anomaly. Although usually asymptomatic, aneurysm formation, dissection, and rupture can occur due to the aberrant vasculature and can be life-threatening. Hybrid, endovascular techniques have been implemented in instances of elective repair of aneurysmal diverticula of Kommerell in similar anatomical settings, but little has been written regarding urgent cases of rupture. We report a case of ruptured right-sided aortic arch with an aberrant left subclavian artery arising from a diverticulum of Kommerell successfully treated with hybrid aortic debranching and thoracic endovascular aortic stenting.
FreedKLowVH. The aberrant subclavian artery. AJR Am J Roentgenol. 1997;168(2):481–484.
2.
EdwardsJE. Anomalies of the derivatives of the aortic arch system. Med Clin North Am. 1948;32:925–948.
3.
CinàCSAlthaniHPasenauJAbouzahrL. Kommerell’s diverticulum and right-sided aortic arch: a cohort study and review of the literature. J Vasc Surg. 2004;39(1):131–139.
4.
DavidianMKeeSTKatoN. Aneurysm of an aberrant right subclavian artery: treatment with PTFE covered stentgraft. J Vasc Surg. 1998;28(2):335–339.
5.
AustinEHWolfeWG. Aneurysm of aberrant subclavian artery with a review of the literature. J Vasc Surg. 1985;2(4):571–577.
KouchoukosNTMasettiP. Aberrant subclavian artery and Kommerell aneurysm: surgical treatment with a standard approach. J Thorac Cardiovasc Surg. 2007;133(4):888–892.
8.
MatsumuraJSLeeWAMitchellRS. The society for vascular surgery practice guidelines: management of the left subclavian artery with thoracic endovascular aortic repair. J Vasc Surg. 2009;50(5):1155–1158.
9.
YamashiroANaganoTKuniyoshiYKiseYMaedaTArakakiR. Endovascular repair of intrathoracic ruptured Kommerell’s diverticulum. Asian Cardiovasc Thorac Ann. 2012;20(5):587–590.
