Hybrid Repair of Penetrating Aortic Ulcer Associated with Right Aortic Arch and Aberrant Left Innominate Artery Arising from Aneurysmal Kommerell's Diverticulum with Simultaneous Repair of Bilateral Common Iliac Artery Aneurysms

We present the first case of a hybrid endovascular approach to a penetrating aortic ulcer on the left descending aorta with a right aortic arch and aberrant left innominate artery arising from an aneurysmal Kommerell's diverticulum. The patient also had bilateral common iliac artery aneurysms. The three-step procedure consisted of a carotid-carotid bypass, followed by endovascular exclusion of the ulcer and the aneurysmal Kommerell's diverticulum, and then completion by covering the iliac aneurysms. The patient had no complications at 18 months after surgery. In such rare configurations, endovascular repair is a safe therapeutic option.