A case of endovascular repair for Kommerell's diverticulum with commercial fenestrated endograft

Kommerell's diverticulum is a rare aortic arch anomaly associated with an increased risk of rupture and aortic dissection. We report a case of an elderly patient with Kommerell's diverticulum and a right-sided aortic arch who was successfully treated using thoracic endovascular aortic repair with a commercially available semi-customized fenestrated endograft (Najuta). Limited supra-aortic debranching was performed to preserve branch perfusion. Postoperative type II endoleak from the left subclavian artery was managed with coil embolization. The patient recovered uneventfully. This case suggests that fenestrated endovascular repair using a commercial device may be a feasible option in selected high-risk patients.