Ruptured Kommerell Diverticulum and Right-Sided Aortic Arch Treated Using a Non–Patient-Specific Custom-Made Triple Arch Branched Endograft

We describe this unique case of a ruptured Kommerell diverticulum treated by adapting a stock-available triple-branched custom-made endograft, nonpatient specific, and bilateral carotid-to-subclavian bypass. The final angiography and the postoperative computed tomographic angiography showed the exclusion of the rupture with excellent endovascular geometric reconstruction and regular patency of all supra-aortic trunks. The patient was extubated on postoperative day 3, and the clinical course was uneventful. This report demonstrates that in extremely selected cases, the adaptation of a non–patient-specific custom-made branched device is feasible and may guarantee excellent results in emergency settings.