DISEASES OF THE AORTA, PULMONARY AND PERIPHERAL VESSELS: Edited by Alan BravermanThe aberrant subclavian artery: approach to managementKarangelis, Dimosa; Loggos, Spirosa; Tzifa, Aphroditeb,c; Mitropoulos, Fotios A.aAuthor Information aDepartment of Cardiac Surgery bDepartment of Congenital Cardiology, Mitera Hospital, Athens, Greece cDivision of Biomedical Engineering and Imaging Sciences, King's College, London, UK Correspondence to Dimos Karangelis, MD, PhD, Department of Cardiac Surgery, Mitera Hospital, 15123 Marousi, Athens, Greece. Tel: +30 21 0619 8100; fax: +30 210 6198555; e-mail: [email protected] Current Opinion in Cardiology: November 2020 - Volume 35 - Issue 6 - p 636-642 doi: 10.1097/HCO.0000000000000793 Buy Metrics Abstract Purpose of review Aberrant subclavian artery (ASCA) represents one of the most common congenital vascular anomalies of the aortic arch. The majority of ASCAs are associated with an aneurysm which occurs at their origin from the descending thoracic aorta, namely, the Kommerell's diverticulum. In this review, we discuss recent data with regards to indications of treatment and surgical management of these anatomical variants. Recent findings Various surgical methods have been described for the repair of ASCA and Kommerell's diverticulum. Traditionally, treatment included open surgery; however, recent studies describe a shift of conventional treatment to more hybrid or endovascular approaches. The heterogeneity in the anatomy and presentation of these clinical entities as well as patient-related factors have prevented conduction of randomized trials for the best available modality of treatment. This dearth of literature is well depicted in the current guidelines. Summary The optimal surgical procedure has to be tailored to every patient according to the presentation, individual anatomy, and patient's risk profile. Conventional surgery for ASCA and Kommerell's diverticulum has acceptable mortality and complication rates, whereas hybrid repairs report encouraging results. Further studies are required to provide sufficient evidence which will formulate a clear frame of treatment indications and optimal surgical methods, as well as evaluate long-term results following hybrid repair. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.