ABSTRACT
A 77-year-old man with an abnormal shadow on chest x-ray film, was found to have Kommerell's diverticulum associated with a right aortic arch 2 years previously. During the period of follow-up, the Kommerell's diverticulum was expanded to 5.3 cm in diameter. CT revealed a right aortic arch with mirror-image branching and Kommerell's diverticulum. To eliminate the risk of rupture, the Kommerell's diverticulum was excluded by deployment of a handmade fenestrated stent-graft using the brachial wire traction technique via the right femoral artery and left brachial artery. At 30-months of follow-up the patient is doing well, with no signs of endoleak or migration. Endovascular repair of Kommerell's diverticulum with a right aortic arch is feasible, safe and effective. This is a rare case of a right aortic arch with Kommerell's diverticulum and without left aberrant subclavian artery.