case_images: PMC5753882_01
case_images: Pre-operative volume rendering CT angiogram imaging demonstrating: (a) a right-sided arch, aberrant origin of the left subclavian artery and (b) a Kommerel's diverticulum at its origin. LSA: left subclavian artery; LCCA: left common carotid artery; RCCA: right common carotid artery; RSA: right subclavian artery.
case_images: 10.1177_2050313X17749082-fig1.jpg
case_images: PMC5753882_01_10.1177_2050313X17749082-fig1.jpg
case_images: fig1-2050313X17749082
case_images: He had been investigated at his local hospital with an oesophagoduodenoscopy (OGD), that had revealed mild extrinsic compression of the oesophagus and a computed tomography (CT) (Figure 1(a) and (b)) scan that revealed a right-sided arch with an aberrant left subclavian artery passing posterior to the oesophagus.
case_images: Intra-arterial DSA in right anterior oblique projection: (a) diagnostic angiogram prior to stent deployment, (b) after stent deployment and cannulation of the posterior tunnel (right common carotid artery), (c) after cannulation of the anterior tunnel (left common carotid artery) and (d) completion angiogram after deployment of bridging stent grafts.
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case_images: PMC5753882_01_10.1177_2050313X17749082-fig2.jpg
case_images: fig2-2050313X17749082
case_images: The endograft was then positioned in the thoracic aorta (Figure 2).
case_images: Three-dimensional volume rendering CT angiogram at 3 months.
case_images: 10.1177_2050313X17749082-fig3.jpg
case_images: PMC5753882_01_10.1177_2050313X17749082-fig3.jpg
case_images: fig3-2050313X17749082
case_images: A CT scan performed on post-operative day 5 revealed good position of the thoracic endograft and carotid stents (Figure 3) with no endoleak or graft kinking.