Endovascular Repair with a Fenestrated Stent Graft for Kommerellfs Diverticulum with a Right Aortic Arch

iDepartment of Cardiovascular Surgery, Otaru Municipal Medical Center, Otaru, Japan, and Department of Emergency Medicine, Sapporo Medical University*, Sapporo, Japanj

Yukihiko Tamiya Johji Fukada Yasuaki Fuzisawa
Yosihiko Kurimoto*
A 77-year-old man with an abnormal shadow on chest x-ray film, was found to have Kommerellfs diverticulum associated with a right aortic arch 2 years previously. During the period of follow-up, the Kommerellfs diverticulum was expanded to 5.3cm in diameter. CT revealed a right aortic arch with mirror-image branching and Kommerellfs diverticulum. To eliminate the risk of rupture, the Kommerellfs diverticulum was excluded by deployment of a handmade fenestrated stent-graft using the brachial wire traction technique via the right femoral artery and left brachial artery. At 30-months of follow-up the patient is doing well, with no signs of endoleak or migration. Endovascular repair of Kommerellfs diverticulum with a right aortic arch is feasible, safe and effective. This is a rare case of a right aortic arch with Kommerellfs diverticulum and without left aberrant subclavian artery.
  Jpn. J. Cardiovasc. Surg. 42:151-154i2013j

KeywordsFright aortic arch, Kommerellfs diverticulum, endovascular repair using a fenestrated stent-graft