Thoracic Endovascular Aortic Repair for Kommerell's Diverticulum

Area of Science:

• Vascular Surgery
• Interventional Cardiology
• Thoracic Surgery

Background:

• Thoracic endovascular aortic repair (TEVAR) is a minimally invasive alternative to open surgery for Kommerell's diverticulum (KD).
• Anatomical complexities like acute aortic arches and aberrant subclavian arteries can challenge TEVAR feasibility for KD.

Purpose of the Study:

• To evaluate the outcomes of thoracic endovascular aortic repair (TEVAR) in patients with Kommerell's diverticulum (KD).

Main Methods:

• A retrospective review of 6 patients with KD who underwent TEVAR between February 2012 and July 2023.
• Assessment of morphological parameters including Kommerell's diverticulum diameter (KDd) and distance to the opposite aortic wall (DAW).
• Subclavian artery management (embolization or reconstruction) was performed as needed.

Main Results:

• Subclavian artery embolization was performed in 4 patients; reconstruction in 2.
• Three cases of intraoperative type 1a endoleaks were successfully managed.
• One patient required open conversion due to graft infection; no other major complications or aneurysmal progression occurred during follow-up (13-83 months).

Conclusions:

• TEVAR demonstrates favorable short- to mid-term outcomes for Kommerell's diverticulum.
• TEVAR may be an effective treatment option for selected KD patients, despite limited long-term data.