Irshad Sana, Adrejiya Parth, Abubaker Mohammad, Whitaker James
Department of Internal Medicine, WellStar Spalding Regional Hospital, Griffin, Georgia, US.
Department of Radiology, Georgia, WellStar Spalding Regional Hospital, Griffin, Georgia, US.
Methodist Debakey Cardiovasc J. 2025 Aug 20;21(1):81-83. doi: 10.14797/mdcvj.1641. eCollection 2025.
Kommerell's diverticulum (KD) is a rare vascular anomaly characterized by aneurysmal dilation of the descending aorta at the origin of an aberrant subclavian artery, which can occur in either a right- or left-sided aortic arch. Aberrant right subclavian arteries are found in approximately 0.5% to 2% of the population while aberrant left subclavian arteries are less common, occurring in only 0.04% to 0.4%. KD is associated with aberrant subclavian arteries in 60% to 82% of cases. It is often identified incidentally during imaging studies performed for unrelated reasons, which contributes to the limited understanding of its natural progression. However, KD carries significant risks, including a 53% chance of aneurysm rupture and a 19% incidence of aortic dissection. As a result, surgical management is generally recommended. Although no standardized treatment exists, options include thoracic endovascular aortic repair, hybrid procedures, and open repair. Intervention is typically advised when the orifice diameter exceeds 3 cm and depth exceeds 5 cm due to elevated rupture risk. We present a case of incidentally detected KD originating from a right aortic arch with an aberrant left subclavian artery.
科默雷尔憩室（KD）是一种罕见的血管异常，其特征为在异常锁骨下动脉起源处的降主动脉呈瘤样扩张，可发生于右侧或左侧主动脉弓。异常右锁骨下动脉在人群中的发生率约为0.5%至2%，而异常左锁骨下动脉则较为少见，仅占0.04%至0.4%。60%至82%的KD病例与异常锁骨下动脉有关。它常因无关原因进行影像学检查时偶然被发现，这导致对其自然病程的了解有限。然而，KD存在重大风险，包括动脉瘤破裂几率为53%以及主动脉夹层发生率为19%。因此，一般建议进行手术治疗。虽然不存在标准化治疗方法，但选择包括胸段血管腔内主动脉修复术、杂交手术和开放修复术。由于破裂风险升高，当开口直径超过3 cm且深度超过5 cm时，通常建议进行干预。我们报告一例偶然发现的起源于右主动脉弓并伴有异常左锁骨下动脉的KD病例。
