Figure 1
Angio-CT. Coronal section: The left subclavian artery originates from the aortic arch (arrows) (a); Axial section: Right-sided aortic arch with a left-sided KD (arrows), the left common carotid artery is located anterior to the aortic arch (b); 3D volume-rendered angiographic reconstruction demonstrates a left-sided KD arising from the aortic arch (arrows), continuing into the left subclavian artery (c). CT, computed tomography; KD, Kommerell diverticulum.
Figure 2
Angio-CT, arterial phase; (a) MPR reconstruction shows a KD measuring 28 mm 24 mm (transverse × anteroposterior diameter), with a base (neck) of 24 mm, localized posterior to the trachea and oesophagus, and just anterior to the T7 vertebra; (b) a right-sided aortic arch is visible (arrow); (c) Best exposure of the KD (arrow). CT, computed tomography; KD, Kommerell diverticulum; multi-planar reconstruction (MPR).
Figure 3
The area between the arrows shows the hyperpulsatility of the anterior oesophageal wall.
Table 1
Adult cases of KD and the algorithm of management.
| Author (Year) | Patient | Clinical presentation | Diagnosis | Treatment | Outcome |
|---|---|---|---|---|---|
| Summa et al.2026 [8] | 80 F; RAA + ALSA + KD (5 cm) | Asymptomaic | Chest X-Ray;CTA | A staged hybrid approach: carotid-subclavian bypass followed by TEVAR with embolization | Successful on intermediate follow-up |
| Sun et al. 2025[9] | 73 F; RAA + KD | Dyspnea (2 months) | CTA | TEVAR | Uneventful |
| Gunga et al. 2025 [10] | 44 F; ARSA + KD | Dysphagia | CTA | Open repair | Resolved |
| Yokawa et al. 2025 [11] | 69 F; RAA + ALSA + KD | Dysphagia | CTA | Arch replacement | Uneventful |
| Sultan et al. 2025 [12] | 66 M; giant KD (7.3 cm) | Incidental → growth | CT | Endovascular staged | Full recovery |
| Nocera et al. 2024 [13] | 56 F; RAA + KD | Chronic cough | CT/MRI | Conservative | Follow-up |
| Overbeek et al.2024 [14] | 67 M; ARSA + KD | Post-op complications | CT/MRI | Surgery + stent | Partial recovery |
| Georgakarakos et al. 2024 [15] | 51 F; double arch + KD | Asymptomatic | CTA | Conservative | Stable |
| Nishio et al. 2024 [16] | 80 F; RAA + KD | Asymptomatic | CTA | Endovascular | Good |
| Kavaliunaite et al. 2024[17] | 50 M; ARSA + KD | Dysphagia | CT | Hybrid repair | Good |
| Akilu et al. 2023[18] | 50 M; RAA + ALSA + KD | Dyspnea, chest pain | CTA | Hybrid repair | Successful |
| Yabu et al. 2023[19] | 62 M; RAA + KD | Post-dissection | CTA | Arch replacement | Successful |
| Iwanaga et al, 2023 [20] | 74 F, 79 F,80 M, 48 M, 52 F; RAA + KD (three cases) ARSA + KD (two cases) | Dysphagia, dyspnea, chest tightness, esophageal stenosis | CT | TEVAR (case 3), no surgery for the remaining cases | Symptomatic improvement |