Abstract:Objective: To investigate the efficacy of hybrid procedures or endovascular repair for type B aortic dissection concomitant with aberrant subclavian artery and Kommerell’s diverticulum. Methods: The clinical data of 5 patients with type B aortic dissection complicated by aberrant subclavian artery and Kommerell’s diverticulum treated from January 2013 to December 2016 were retrospectively analyzed. The patterns of aortic arch variations, the location of the proximal tear and surgical options as well as the perioperative and follow-up results of the patients were summarized. Results: According to the patterns of aortic arch variations and location of the proximal tear of the patients, 2 cases underwent hybrid surgery and 3 cases underwent endovascular aortic repair alone. The operative time ranged from 90 to 538 min, with an average of 294 min. Postoperative immediate angiography showed the completely occluded tears, and normal blood flow in the branches of the aortic arch or bypass grafts. One patient died of massive cerebellar infarction on one week after operation but the other 4 patients were alive during postoperative follow-up period, and no symptoms of brain or upper limb ischemia were noted and no stent displacement or endoleak occurred. Conclusion: The variations of aortic arch branches along with the vascular frangibility of the Kommerell’s diverticulum cause surgical inconvenience. Hybrid surgery or endovascular repair is feasible in treatment of aortic dissection concomitant with aberrant subclavian artery and Kommerell’s diverticulum. However, the treatment experience for this condition should be further enhanced, and the long-term efficacy remains to be determined.