Universidade Federal de Santa Catarina, Santa Catarina, Brazil.
J Vasc Surg. 2013 Apr;57(4):1123-5. doi: 10.1016/j.jvs.2012.10.008. Epub 2013 Jan 9.
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.
我们描述了一例累及右位主动脉弓远端和异常左锁骨下动脉（LSA）起源的 Kommerell 憩室。患者接受了改良的 Valient 覆膜支架（美敦力，明尼苏达州明尼阿波利斯市）的完全腔内修复术，该支架附有一个分支以保持 LSA 通畅。术后计算机断层扫描显示病变完全被排除，无内漏。在这种情况下，使用“定制的超适应证”器械来治疗特殊情况是可行的，可以保持 LSA 的通畅，而不会导致手臂跛行或需要补充手术旁路。
