case_images: PMC9699872_01
case_images: Computed tomographic angiography of the head-and-neck arteries (Lateral oblique view) shows diffuse stenosis of nearly 30-50% in the left common carotid artery and internal carotid artery.
case_images: SNI-13-493-g001.jpg
case_images: PMC9699872_01_SNI-13-493-g001.jpg
case_images: F1
case_images: The circle of Willis was normal with a hypoplastic left A1 segment of the anterior cerebral artery with no vessel wall irregularities [Figure 1].
case_images: (a) Computed tomography angiography (CTA) of the thoracic aorta (anteroposterior view) revealing the branches of the aortic arch in the following order: left common carotid artery, right common carotid artery, right subclavian artery, and finally, the aberrant left subclavian artery with aneurysmal origin (Kommerell's diverticulum). (b) CTA of the abdominal aorta (anteroposterior view) shows the pancake kidney.
case_images: SNI-13-493-g002.jpg
case_images: PMC9699872_01_SNI-13-493-g002.jpg
case_images: F2
case_images: Type 2 RAA, with ALSA, which had a bullous dilatation at its origin that suggests Kommerell's diverticulum [Figure 2].
case_images: Catheter Angiography of the aortic arch branches shows a right-sided arch, aberrant left subclavian artery with kommerell's diverticulum (a,b). c-f: showing the right (dominant) and left (hypoplastic) vertebral artries injection in PA and Lateral view respectively.
case_images: SNI-13-493-g003.jpg
case_images: PMC9699872_01_SNI-13-493-g003.jpg
case_images: F3
case_images: The origin of the left SCA was dilated, known as Kommerell's diverticulum [Figure 3].
case_images: Catheter angiography of the aortic arch shows the left and right carotid arteries being barely visible after injection of the contrast material in the ascending aorta.
case_images: SNI-13-493-g004.jpg
case_images: PMC9699872_01_SNI-13-493-g004.jpg
case_images: F4
case_images: After several attempts of catheter navigation, the injection of the contrast material at the ascending aorta successfully visualized them only [Figure 4].