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Coil Embolization of Diverticulum of Kommerell: A Targeted Hybrid Endovascular Technique
Peter S Y Yu1, Simon C H Yu2, Cyrus T C Ng1
1Division of Cardiothoracic Surgery, Department of Surgery, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong.
Insights
A patient with aberrant right subclavian artery and Kommerell's diverticulum underwent successful endovascular embolization. This minimally invasive approach avoided thoracic aorta coverage and access vessel trauma, offering a safe treatment option.
Area of Science:
- Vascular Surgery
- Interventional Cardiology
- Endovascular Techniques
Background:
- Aberrant origin of the right subclavian artery (ARSA) is a rare congenital anomaly.
- Kommerell's diverticulum, often associated with ARSA, can lead to dysphagia, chest pain, or aortic dissection.
- Surgical management historically involved open repair, carrying significant risks.
Abstract:
A 57-year-old man was incidentally found to have a dissected diverticulum of Kommerell originating from aberrant origin of right subclavian artery during follow-up for treated colon cancer. A right carotid-axillary bypass was followed by embolization of aberrant artery and the diverticulum by deployment of multiple detachable coils using the Penumbra Ruby System (Penumbra, Alameda, CA). Angiography after embolization showed exclusion of flow to the aberrant artery and a patent right carotid-axillary bypass. The patient recovered uneventfully and remained well for 12 weeks after the operation, without any complications. We believe this targeted endovascular approach can avoid complications related to the coverage of thoracic aorta and reduce the risk of access vessel trauma.
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