PMC3561161_01
CTA demonstrated a right-sided aortic arch and a right descending thoracic aorta, a type B aortic.
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F1
A 65-year-old man was admitted to our institution with acute onset chest and back pain and computer tomographic angiography (CTA) demonstrated a right-sided aortic arch; a right descending aortic dissection with an aberrant left subclavian artery (LSA) arising from Kommerell's diverticulum (Figure 1).
Digital subtraction angiography showed a right-sided aortic arch and the right vertebral artery is dominant. A LAO projection showed the ordering of the aortic arch branches as left common carotid, right common carotid, right subclavian and left subclavian arteries from proximal to distal.
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F2
Digital subtraction angiography (DSA) showed a right-sided aortic arch, type B aortic dissection, and dominanted right vertebral artery (Figure 2).
Postoperative angiogram after graft-stent implantation showed no evidence of endoleak, the false lumen of aortic dissection disappeared.
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F3
Completion angiogram revealed no evidence of type I endoleak, sealing of the false lumen, no visualization of left subclavian artery and no visceral vessels malperfused (Figure 3).
After 18 months follow-up, CTA documented that the false lumen was largely thrombosed only with a mild type II endoleak and a mild descending aortic expansion.
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F4
The CTA demonstrated that the false lumen was largely thrombosed only with a mild type II endoleak and a mild descending aortic expansion (The size of descending aortic is 66mm) (Figure 4).