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Journal articles on the topic 'Right subclavian artery'

Author: Grafiati

Published: 3 June 2025

Last updated: 19 July 2025

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1

Fazan, Valéria Paula Sassoli, Rogério Alves Ribeiro, João Alberto S. Ribeiro, and Omar Andrade Rodrigues Filho. "Right retroesophageal subclavian artery." Acta Cirurgica Brasileira 18, suppl 5 (2003): 54–56. http://dx.doi.org/10.1590/s0102-86502003001200020.

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PURPOSE: The subclavian arteries can vary on their origin, course or length. One of the most common anatomical variations is the right subclavian artery originating as the last branch of the aortic arch. This artery is known as a retroesophageal right subclavian artery or "lusory artery". The right retroesophageal subclavian artery usually is described as not producing symptoms, being most discoveries coincidental. Nevertheless, it may be the site of formation of atherosclerotic plaque, inflammatory lesions or aneurysm. CASE REPORT: The present study describes a case of right retroesophageal subclavian artery and discusses the findings according to their clinical and surgical implications. CONCLUSION: The anatomic and morphologic variations of the aortic arch and its branches are significant for diagnostic and surgical procedures in the thorax and neck. If a right retroesophageal subclavian artery is diagnosed during aortic arch repair, corrective surgery should be considered. Intensive care patients should be screened before long term placement of nasogastic tube, in order to avoid fistulization and fatal hemorrhage.

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2

Zhang, Ping, Daiqi Chen, Daishi Tian, et al. "Simultaneous Kissing Stenting: A Valuable Technique for Reconstructing the Stenotic Initial Segment of the Right Subclavian Artery." Interventional Neurology 6, no. 1-2 (2017): 65–72. http://dx.doi.org/10.1159/000455288.

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Atherosclerotic stenosis or occlusion often involves the subclavian artery. For lesions that are close to the orifice of the right subclavian artery, stenting of the right subclavian artery itself blocks the pathway from the innominate artery to the right carotid artery and causes problems in patients with multiple angiostenosis, especially involving the right carotid system. In this study, we report 2 cases using simultaneous kissing stenting (SKS) of the right subclavian artery and the right carotid artery to relieve right subclavian stenosis and maintain right carotid system patency. Standard stenting methods were used to perform SKS. Two self-expanding stents were implanted simultaneously into the initial segment of the right subclavian artery and the right carotid artery, forming a “Y” shape, with the overlap of the proximal segments in the innominate artery ≥5 mm. After SKS, the stenosed right subclavian artery was dilated, and the patency of the right carotid system was maintained. The symptoms of patients were relieved and the stents were intact at several months of follow-up. In conclusion, SKS of the right subclavian artery and the right carotid artery might be a safe and effective procedure when the stenotic or occlusive lesion in the initial segment of the right subclavian artery is close to the orifice, and lesions (or potential ones) exist in the right carotid system.

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3

Kanaskar, Neelesh, P. Vatsalaswamy, Preeti Sonje, and Vaishali Paranjape. "Retroesophageal Right Subclavian Artery." Advances in Anatomy 2014 (October 2, 2014): 1–3. http://dx.doi.org/10.1155/2014/934825.

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During routine dissection of head and neck region in a 65-year-old female cadaver variation in the origin of right subclavian artery was found. The right subclavian artery originated as a direct branch of arch of aorta distal to the origin of left subclavian artery and it was found passing behind esophagus (retroesophageal) and ascending upwards to the right side while the left subclavian artery originated normally from arch of aorta distal to the origin of left common carotid artery. Anomalous variations in the origin and course of arteries have serious implications in angiographic and surgical procedures; hence it is of great importance to be aware of such possibilities of variations.

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4

Wang, Peijian, Qiulin Wang, Chen Bai, and Peng Zhou. "Iatrogenic aortic dissection following transradial coronary angiography in a patient with an aberrant right subclavian artery." Journal of International Medical Research 48, no. 8 (2020): 030006052094378. http://dx.doi.org/10.1177/0300060520943789.

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An aberrant right subclavian artery is a congenital aortic arch anomaly in which the right subclavian artery originates from the proximal descending aorta. The presence of an aberrant right subclavian artery can make right transradial coronary interventions more difficult and even lead to complications. Iatrogenic intramural hematomas and dissection of aberrant right subclavian arteries during transradial coronary angiography have been previously reported. We herein report a case of iatrogenic aortic dissection following attempts to perform right transradial coronary angiography in a patient with an aberrant right subclavian artery. Clinicians should be vigilant for the presence of an aberrant right subclavian artery during right transradial coronary angiography and ensure gentle manipulation of wires and catheters to avoid complications.

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5

Law, Yuk, Jeff Smallhorn, and Ian Adatia. "Echocardiographic delineation of anomalous origin of the right subclavian artery from the right pulmonary artery." Cardiology in the Young 7, no. 3 (1997): 328–30. http://dx.doi.org/10.1017/s1047951100004236.

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AbstractWe describe a case of anomalous origin of the right subclavian artery from the right pulmonary artery detected by cross-sectional echocardiography in an infant with type B interruption of the aortic arch. Preoperative recognition and surgical reimplantation of the right subclavian artery are important to prevent subsequent subclavian steal syndrome.

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6

Riley, Jason T. "Right Subclavian Artery Aneurysm." Journal of Diagnostic Medical Sonography 25, no. 5 (2009): 255–58. http://dx.doi.org/10.1177/8756479309333980.

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7

Fernando, Rohesh J., Jason M. Altman, Blaine Farmer, and Chandrika Garner. "Aberrant Right Subclavian Artery." Anesthesiology 130, no. 4 (2019): 615–16. http://dx.doi.org/10.1097/aln.0000000000002567.

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8

Bull, Philippe G., and Helmuth Denck. "Aberrant right subclavian artery." European Journal of Vascular Surgery 8, no. 6 (1994): 757–60. http://dx.doi.org/10.1016/s0950-821x(05)80661-9.

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9

Munnell, Edward R. "Aberrant Right Subclavian Artery." Annals of Thoracic Surgery 46, no. 1 (1988): 118. http://dx.doi.org/10.1016/s0003-4975(10)65871-7.

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10

Ansari, Zeeshan Ali, and Kishalay Datta. "Thrombosis of Aberrant Right Subclavian Artery Presenting As Myocardial Infarction." Indian Journal of Emergency Medicine 7, no. 2 (2021): 29–33. http://dx.doi.org/10.21088/ijem.2395.311x.7221.5.

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Aberrant right subclavian artery (ARSA) is a rare anomaly, in which the right subclavian artery arises directly from the aortic arch instead of originating from the brachiocephalic artery. This anomaly should be taken into consideration during surgical procedures around the esophagus, such as esophagectomy. Any unintentional injury of this artery during surgical procedures could be extremely life-threatening. The patient was an 88-year-old male, known case of hypertension, CAD, COPD, presented with the chief complaint of chest pain for 2 days associated with the history of right-hand weakness and numbness for 1 week. ECG has done suggestive of Sinus Rhythm with LBBB Trop I – 6.1 ng/ml Coronary Angiography LMCA- Normal LAD- Mid LAD 80% stenosis LCX- Proximal 99-100% occluded RCA- normal CT ANGIO right upper limb done findings revealed anomalous retro esophageal course of right subclavian artery with narrowing at its origin and a small thrombus in juxta osteal segment. Thrombus of 6.7 cm long segment of the distal third of right brachial artery with the reformation of brachial artery at the level of elbow joint along with thrombosis of right ulnar artery at a short distance from its origin. Keywords: Aberrant right subclavian artery; Thrombosis; Myocardial infarction.

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11

Kumar, Parveen, Mona Bhatia, Khemendra Kumar, and Shashank Jain. "Isolated right subclavian artery with interrupted aortic arch, ventricular septal defect and bilateral patent ductus arteriosus: a rare congenital anomaly." BMJ Case Reports 14, no. 7 (2021): e239654. http://dx.doi.org/10.1136/bcr-2020-239654.

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Isolation of the left subclavian artery or its anomalous origin from the pulmonary artery has been documented in several cases, especially in association with a right-sided aortic arch. However, similar anomaly involving the right subclavian artery has been less frequently reported. Isolated right subclavian artery in association with interrupted aortic arch (IAA) is extremely rare, and only three cases have been reported so far. Here, we have presented yet another case of isolated right subclavian artery associated with ventricular septal defect, type B IAA and bilateral patent ductus arteriosus.

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12

Krupiński, Maciej, Małgorzata Irzyk, Zbigniew Moczulski, Robert Banyś, Ireneusz Dwojak, and Małgorzata Urbańczyk-Zawadzka. "CT evaluation of aberrant right subclavian artery: anatomy and clinical implications." Cardiology in the Young 29, no. 2 (2018): 128–32. http://dx.doi.org/10.1017/s1047951118001907.

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AbstractPurposeThe aim of the study was to perform CT angiography-based evaluation of aberrant right subclavian artery prevalence, anatomy, and its influence on clinical symptoms.MethodsA total of 6833 patients who underwent 64-slice or dual-source CT angiography and those who revealed aberrant right subclavian artery underwent evaluation of its anatomy and were interviewed for the presence of clinical symptoms.ResultsAberrant right subclavian artery was found in 32 (0.47%) patients consisting of 13 males and 19 females, with mean age of 60.8±13.4 years. Among the interviewed 30 (94%) patients, oesophageal compression was observed in 14 cases (47%) and tracheal compression in three cases (10%). None of the patients underwent surgery related to aberrant right subclavian artery. Dysphagia was the most common clinical symptom in nine cases (30%), and in those patients the median distance between aberrant right subclavian artery and trachea was lower (4 mm) than in individuals without dysphagia (7.5 mm) (p = 0.009). The median lumen area of the aberrant right subclavian artery at the level of oesophagus was higher in patients with dysphagia (208 mm2) compared with individuals without dysphagia (108 mm2) (p = 0.01).ConclusionsAberrant right subclavian artery is a rare occurring abnormality in CT angiography. In the evaluated adult population, the most common symptom was dysphagia, which occurred in patients with decreased distance between aberrant right subclavian artery and trachea and increased lumen area of the aberrant artery at the level of compressed oesophagus.

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13

Miller, Stephen G., Michael J. Campbell, Piers C. A. Barker, and Kevin D. Hill. "Isolated right subclavian artery arising from the right pulmonary artery via a right-sided ductus arteriosus with associated pulmonary steal phenomenon." Cardiology in the Young 22, no. 2 (2011): 216–18. http://dx.doi.org/10.1017/s1047951111001065.

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AbstractWe present a patient with DiGeorge syndrome and an isolated right subclavian artery arising from the right pulmonary artery via a right-sided ductus arteriosus. The patient showed a subclavian and pulmonary steal with perfusion of the right arm and right lung via retrograde circulation in the right vertebral artery. The patient underwent successful surgical repair.

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14

Lamb, KM, N. Moudgill, AK Whisenhunt, et al. "Hybrid endovascular treatment of an aberrant right subclavian artery with Kommerell aneurysm." Vascular 22, no. 6 (2014): 458–63. http://dx.doi.org/10.1177/1708538113518531.

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Aberrant right subclavian artery is a rare anatomical finding of abnormal embryologic development of the dorsal aorta and right subclavian artery. An associated aortic outpouching, or Kommerell diverticulum, may develop at the origin of the aberrant right subclavian artery. Given historically high rates of aneurysm rupture and mortality, early repair is indicated. Successful aneurysm exclusion can be accomplished with thoracic endovascular stent grafting following open carotid-subclavian bypass, maintaining upper extremities perfusion. Such hybrid techniques offer a decrease in mortality and complication rates. Herein, we describe a successful repair of a symptomatic (dysphagia, weight loss) aberrant right subclavian artery with Kommerell diverticulum using this hybrid open-endovascular approach.

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15

Smith, Julian A., Michael J. Hirschklau, and Bruce A. Reitz. "An unusual presentation of isolation of the right subclavian artery." Cardiology in the Young 4, no. 2 (1994): 181–83. http://dx.doi.org/10.1017/s1047951100002171.

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SummaryIsolation of the right subclavian artery from the aortic arch is a rare malformation. When isolated, the artery originates from the right pulmonary artery via a right-sided arterial duct, which may be patent or closed at the time of presentation. Intracardiac or other anomalies of the great vessels are commonly associated with this lesion. We present a case of isolation of the right subclavian artery which was initially diagnosed as persistent patency of a left-sided arterial duct. Surgical correction was eventually achieved by disconnecting the right subclavian artery from the right pulmonary artery and translocating it to the ascending aorta.

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16

Liu, Ya-dong, Zhi-qiang Li, Jing-jing Fu, and Ya-jun E. "A rare anomalous origin of right vertebral artery with double branch: First case report." Interventional Neuroradiology 24, no. 2 (2017): 225–28. http://dx.doi.org/10.1177/1591019917733126.

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Vertebral artery origin anomalies are typically incidental findings during angiography. We present an extremely rare variant in which the right vertebral artery has a double origin from the right subclavian artery and right common carotid artery in association with an aberrant right subclavian artery, which has never been reported before.

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17

Lee, Thomas S., and George L. Hines. "Cerebral Embolic Stroke and Arm Ischemia in a Teenager With Arterial Thoracic Outlet Syndrome: A Case Report." Vascular and Endovascular Surgery 41, no. 3 (2007): 254–57. http://dx.doi.org/10.1177/1538574407299780.

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A rare presentation of arterial thoracic outlet syndrome (TOS) is described in a young woman. Arterial TOS caused by a cervical rib produced acute upper extremity ischemia due to subclavian artery aneurysm formation. Clinical presentation also included left hemiparesis caused by right subclavian artery thrombosis and retrograde embolization of thrombus via the common carotid artery to the right middle cerebral artery distribution. Surgical repair of the subclavian artery was performed, but permanent neurologic deficit remained. Acute thrombosis of the right subclavian artery can produce cerebrovascular complication. The assessment of such risk in patients with arterial TOS is warranted and the arterial lesion corrected surgically.

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18

Jan, Sheng-Ling, Ming-Chih Lin, and Sheng-Ching Chan. "Mid-term follow-up study of neonatal isolated aberrant right subclavian artery." Cardiology in the Young 28, no. 8 (2018): 1024–30. http://dx.doi.org/10.1017/s1047951118000872.

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AbstractBackgroundAberrant right subclavian artery is the most common congenital aortic arch anomaly. There are a few reports concerning the clinical manifestations and follow-up of this CHD detected by echocardiographic screening.MethodsA total of 1737 full-term neonates, with a male-to-female ratio of 900:837, received echocardiographic screening. Neonates with or without isolated aberrant right subclavian artery were studied during infancy.ResultsAmong the 1737 cases, a total of 15 (0.86%) female-predominant neonates, with a male-to-female ratio of 6:9, had isolated aberrant right subclavian artery. They were compared with 20 age- and gender-matched normal neonates. There were no significant differences in maternal age, gestational age, or para gravity between the two groups, except for birth size (birth length- and weight-for-age percentiles, p = 0.006 and 0.045, respectively), which was smaller in the aberrant right subclavian artery group. Although there were no significant differences in developmental history, gastrointestinal, or respiratory symptoms, neonates with aberrant right subclavian artery had a higher incidence of mild developmental delay and feeding difficulty than normal infants (21 versus 0%, p = 0.061; 36 versus 20%, p = 0.264, respectively). The growth rates of body length and weight during infancy were not significantly different between the two groups.ConclusionsEchocardiography can be applied as a first-line investigation in the diagnostic work-up for aberrant right subclavian artery. Neonates with aberrant right subclavian artery had a smaller size at birth, although growth rates were not significantly different from those of normal infants. This study does not support an active surgical policy for asymptomatic infants with isolated aberrant right subclavian artery. A larger study and longer follow-up of affected infants is recommended.

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19

Buffoli, Barbara, Vincenzo Verzeletti, Lena Hirtler, Rita Rezzani, and Luigi Fabrizio Rodella. "Retroesophageal right subclavian artery associated with a bicarotid trunk and an ectopic origin of vertebral arteries." Surgical and Radiologic Anatomy 43, no. 9 (2021): 1491–95. http://dx.doi.org/10.1007/s00276-021-02746-1.

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AbstractA rare branching pattern of the aortic arch in a female cadaver is reported. An aberrant right subclavian artery originated from the distal part of the aortic arch and following a retroesophageal course was recognized. Next to it, from the left to the right, the left subclavian artery and a short bicarotid trunk originating the left and the right common carotid artery were recognized. An unusual origin of the vertebral arteries was also identified. The left vertebral artery originated directly from the aortic arch, whereas the right vertebral artery originated directly from the right common carotid artery. Retroesophageal right subclavian artery associated with a bicarotid trunk and ectopic origin of vertebral arteries represents an exceptional and noteworthy case.

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20

Agrawal, H., and E. R. Volkmann. "Aberrant right subclavian artery aneurysm." Internal Medicine Journal 41, no. 8 (2011): 641–42. http://dx.doi.org/10.1111/j.1445-5994.2011.02542.x.

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21

Ishihara, H., D. San Millán Ruíz, G. Abdo, et al. "Combination of Rare Right Arterial Variation with Anomalous Origins of the Vertebral Artery, Aberrant Subclavian Artery and Persistent Trigeminal Artery." Interventional Neuroradiology 17, no. 3 (2011): 339–42. http://dx.doi.org/10.1177/159101991101700309.

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A 32-year-old woman hospitalized for subarachnoid hemorrhage showed rare arterial variation on the right side with anomalous origins of the vertebral artery, aberrant subclavian artery and persistent trigeminal artery. Angiography showed the right vertebral artery to originate from the right common carotid artery, the right subclavian artery to arise separately from the descending aorta, and persistent trigeminal artery on the right side. The possible embryonic mechanism of this previously unreported variant combination is discussed.

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22

Burket, Grace J., Mashhood Kakroo, and Mark W. Burket. "Stent placement for long-segment total occlusion of an aberrant right subclavian artery: A 7-year follow-up." SAGE Open Medical Case Reports 8 (January 2020): 2050313X2095374. http://dx.doi.org/10.1177/2050313x20953749.

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An aberrant origin of the right subclavian artery arising as the most distal vessel from the aortic arch is an uncommon but clinically important anomaly. Its abnormal course may result in esophageal compression with dysphagia, or tracheal compression resulting in asthma or stridor, and can greatly complicate radial artery access for coronary angiography. When an aberrant right subclavian artery is obstructed by atherosclerotic plaque, it may produce symptoms of arm ischemia such as pain and weakness. For the past 75 years, the standard treatment approach for symptomatic aberrant right subclavian artery has been surgical correction. There are only three case reports of percutaneous therapy, all for nonocclusive stenosis. There are no reported cases of percutaneous treatment of a completely occluded aberrant right subclavian artery. We report a patient with exertional right arm heaviness and weakness who was found to have a 60-mm long aberrant right subclavian artery occlusion. The blockage was successfully treated with angioplasty and placement of a single stent using percutaneous vascular access. Chest computerized tomography and duplex ultrasonography 5 years after treatment demonstrated a patent stent. At 7-year follow-up, she remained symptom-free and had a normal radial pulse. This case represents the first report of total occlusion of aberrant right subclavian artery treated percutaneously. Long-term durability supports this as a viable alternative to surgery in appropriately selected patients.

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23

Ghincea, Christian V., Yuki Ikeno, Michael J. Weyant, John D. Mitchell, Muhammad Aftab, and T. Brett Reece. "Right Thoracoscopic Aberrant Right Subclavian Artery Division and Subclavian-Carotid Transposition." Annals of Thoracic Surgery 110, no. 5 (2020): e431-e433. http://dx.doi.org/10.1016/j.athoracsur.2020.03.106.

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24

Nair, Kannan R., Harilal Vasu, Aju Jacob, and Bashi V. Velayudhan. "Repair of Left Subclavian Artery and Aberrant Right Subclavian Artery Aneurysms." Asian Cardiovascular and Thoracic Annals 18, no. 6 (2010): 581–82. http://dx.doi.org/10.1177/0218492310384156.

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25

Yoshizumi, Ko, Shingo Kasahara, and Shunji Sano. "Anomalous right subclavian artery from pulmonary artery." Asian Cardiovascular and Thoracic Annals 24, no. 1 (2014): 115. http://dx.doi.org/10.1177/0218492314542288.

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26

Shires, Courtney Brooke, and Michael J. Rohrer. "Anomalous Right Subclavian Artery-Esophageal Fistulae." Case Reports in Vascular Medicine 2018 (2018): 1–5. http://dx.doi.org/10.1155/2018/7541904.

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An aberrant right subclavian artery (ARSA) is the most common aortic arch anomaly, but only 19 previous cases of ARSA-esophageal fistula have been reported. Six patients have survived their bleeding episode. We describe the case of a 44-year-old woman who developed massive hemoptysis. Laryngoscopy, bronchoscopy, head and neck angiogram, and median sternotomy did not reveal what was presumed initially to be a tracheoinnominate fistula. Contrasted CT showed an anomalous subclavian artery posterior to the esophagus. Given the technical challenge of approaches for this pathology, the patient was unfit for open surgical repair. Therefore, endovascular covered stent grafts were deployed spanning the segment of the subclavian artery in continuity with the esophagus, via a right brachial artery approach. Unfortunately, the patient died after successful placement of the grafts.

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27

Nuri Tuncer, Osman, Celal Çınar, and Yüksel Atay. "Surgical management of subclavian steal syndrome in a patient with an aberrant right subclavian artery." Turkish Journal of Thoracic and Cardiovascular Surgery 33, no. 1 (2024): 102–5. https://doi.org/10.5606/tgkdc.dergisi.2024.25683.

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The coexistence of subclavian steal syndrome and aberrant right subclavian artery is a very rare condition. Herein, we report a case of a 73-year-old male patient with subclavian steal syndrome who underwent carotid-subclavian bypass surgery. A single supraclavicular incision was made and carotid-subclavian bypass operation was performed using a Dacron graft in the patient. The patient was asymptomatic at the three-month follow-up with no complications. Carotid-subclavian bypass appears to be the most effective method in treating symptomatic cases of subclavian steal syndrome with an aberrant right subclavian artery.

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28

Wang, Jian, Jie Chu, Lihua Zhang, et al. "Carotid-Vertebral or Carotid-Subclavian Transpositions in Supra-Aortic Steno-Occlusive Diseases When Endovascular Therapy Is Unfeasible or Unsuccessful." International Surgery 105, no. 1-3 (2021): 455–63. http://dx.doi.org/10.9738/intsurg-d-17-00097.1.

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Background and purpose Despite advances in endovascular therapies, some patients experience vertebral artery stenosis or subclavian artery occlusion and may not benefit from less-invasive angioplasty/stenting. This study described 4 cases in which carotid-vertebral transposition (CVT) or carotid-subclavian transposition (CST) was adapted when endovascular treatment was unfeasible or unsuccessful. Presentation Case 1: A 65-year-old woman presented with severe stenosis of the right vertebral artery ostium, dysplastic left vertebral artery, and aneurysmal dilatation of proximal right subclavian artery and brachiocephalic trunk. Case 2: A 23-year-woman had severe stenosis at the first portion of left vertebral artery caused by Takayasu's arteritis. Because endovascular intervention was unfeasible, CVTs were performed in cases 1 and 2. Case 3: A 73-year-old man presented with total occlusion of the proximal right subclavian artery and severe stenosis of the right internal carotid artery. Case 4: A 58-year-old man experienced complete occlusion of the left subclavian artery and severe stenosis of the left common carotid artery. Duplex ultrasonography showed reverse flow in the vertebral artery in keeping with vertebral steal syndrome. Endovascular treatment was unsuccessful because the wire did not cross the occlusion of the subclavian artery. CSTs were performed with concurrent ipsilateral carotid endarterectomy in cases 3 and 4. Conclusion The present case series demonstrated that CST and CVT were effective treatment modalities for subclavian or vertebral artery lesions. Although endovascular stenting and angioplasty have been advocated as first-line management, CST and CVT should be considered as the remedy when endovascular intervention is unsuccessful or unfeasible.

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Jha, Nihar, Gregory Selkirk, Matthew Thomas Crockett, and Timothy John Phillips. "Transradial intracranial aneurysm treatment via an aberrant right subclavian artery." BMJ Case Reports 13, no. 6 (2020): e234078. http://dx.doi.org/10.1136/bcr-2019-234078.

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We report two cases of successfully treated intracranial saccular aneurysms via transradial access with aberrant right subclavian artery anatomy. Two patients aged 74 and 82 years with anterior communicating artery aneurysms deemed suitable for endovascular treatment and anomalous aortic arch anatomy (aberrant right subclavian artery) underwent successful treatment with transradial access. Transradial access was obtained in both patients, in the first patient, without prior knowledge of the aortic arch anatomy. Aberrant right subclavian artery anatomy was negotiated, and the aneurysms were successfully treated in both cases with intrasaccular flow disrupting devices (WEB-SL).

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30

Ankolekar, Vrinda Hari, Antony Sylvan D'Souza, Lydia S. Quadros, Mamatha H., Suhani S., and Hemalatha S. Bangera. "VARIOUS ANOMALIES OF THE THORAX." Journal of Health and Allied Sciences NU 04, no. 01 (2014): 138–40. http://dx.doi.org/10.1055/s-0040-1703753.

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Abstract:During routine dissection of the thoracic region of a 55-year old male cadaver, in the department of Anatomy, Kasturba Medical College, Manipal, various anomalies were noticed in the thoracic region.a) The arch of aorta gave rise to four branches, the right common carotid artery, left common carotid artery, left subclavian artery and a right subclavian artery. The origin of the right subclavian artery was to the left of the midline and in order to reach the right arm, the artery coursed behind both the trachea and oesophagus.b) Cervical rib was present on both the sides.c) Thoracic duct coursed on the same side without crossing to the left at the T5 vertebral level.d)Hemiazygos vein was underdeveloped.

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Oswal, Nilesh, Georgi Christov, Shankar Sridharan, Sachin Khambadkone, Catherine Bull, and Ian Sullivan. "Aberrant subclavian artery origin in tetralogy of Fallot with pulmonary stenosis is associated with chromosomal or genetic abnormality." Cardiology in the Young 24, no. 3 (2013): 478–84. http://dx.doi.org/10.1017/s1047951113000644.

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AbstractWe determined the relationship between aortic arch anatomy in tetralogy of Fallot with pulmonary stenosis and chromosomal or genetic abnormality, by performing analysis of 257 consecutive patients undergoing surgical repair from January, 2003 to March, 2011. Chromosomal or genetic abnormality was identified in 49 of the 257 (19%) patients. These included trisomy 21 (n = 14); chromosome 22q11.2 deletion (n = 16); other chromosomal abnormalities (n = 9); CHARGE (n = 2); Pierre Robin (n = 2); and Kabuki, Alagille, Holt–Oram, Kaufman McKusick, Goldenhar, and PHACE (n = 1 each). Aortic anatomy was classified as left arch with normal branching, right arch with mirror image branching, left arch with aberrant right subclavian artery, or right arch with aberrant left subclavian artery. Associated syndromes occurred in 33 of 203 (16%) patients with left arch and normal branching (odds ratio 1); three of 36 (8%) patients with right arch and mirror image branching (odds ratio 0.4, 95% confidence interval 0.1–1.6); seven of eight (88%) patients with left arch and aberrant right subclavian artery (odds ratio 36, 95% confidence interval 4–302); and six of 10 (60%) patients with right arch and aberrant left subclavian artery (odds ratio 8, 95% confidence interval 2–26). Syndromes were present in 13 of 18 (72%) patients with either right or left aberrant subclavian artery (odds ratio 15, 95% confidence interval 4–45). Syndromes in patients with an aberrant subclavian artery included trisomy 21 (n = 4); chromosome 22q11.2 deletion (n = 5); and Holt–Oram, PHACE, CHARGE, and chromosome 18p deletion (n = 1 each). Aberrant right or left subclavian artery in tetralogy of Fallot with pulmonary stenosis is associated with an increased incidence of chromosomal or genetic abnormality, whereas right aortic arch with mirror image branching is not. The assessment of aortic arch anatomy at prenatal diagnosis can assist counselling.

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McElhinney, Doff B., Norman H. Silverman, Michael M. Brook, V. Mohan Reddy, and Frank L. Hanley. "Rare forms of isolation of the subclavian artery: echocardiographic diagnosis and surgical considerations." Cardiology in the Young 8, no. 3 (1998): 344–51. http://dx.doi.org/10.1017/s1047951100006855.

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AbstractIsolation of the subclavian artery is an unusual anomaly in which the subclavian artery arises not from the aortic arch but from a pulmonary artery via an arterial duct. Such isolation most often occurs with a right aortic arch, and in lesions frequently associated with a right arc, such as tetralogy of Fallot. Since1994, we have undertaken surgery in four young infants with isolated subclavian arteries and unusual associated anomalies, including one with atrioventricular septal defect and common valvar orifice, two with interruption of a left aortic arch and one with interruption of a right aortic arch. In both patients with interrupted left arch, the isolated subclavian artery was diagnosed preperatively by echocardiography. We emphasize the significant issues.

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Gooding, Rose C., and George L. Hines. "A Case of Right Subclavian Artery Agenesis." AORTA 10, no. 03 (2022): 131–34. http://dx.doi.org/10.1055/s-0042-1743534.

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AbstractThe authors present a 12-year-old male with an asymptomatic absence of the proximal right subclavian artery. On physical examination, his right brachial, radial, and ulnar pulses were diminished compared with the left side. Computed tomographic angiography revealed that the right subclavian artery was supplied from the anterior right internal mammary artery. A description of the acquired and congenital aortic arch anomalies and thoracic outlet syndrome differential diagnoses is provided.

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Ionescu, C. A., Irina Pacu, and H. Haradja. "Aberrant right subclavian artery - a marker for chromosomal abnormalities?" ARS Medica Tomitana 18, no. 4 (2012): 164–67. http://dx.doi.org/10.2478/v10307-012-0040-8.

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Abstract The aberrant right subclavian artery or the aberrant right subclavian artery syndrome is a rare anatomical variant of the right subclavian artery origin but it is the most common form of congenital anomaly of the aortic arch. The normal or abnormal appearance of the aortic arch can be explained by the regression or the persistence of one or other of the two embryonic aortic arches. The regression of the right aortic arch after the origin of the right subclavian artery will result in a normal aspect of left aortic arch with normal vascular anatomy. While the right ductus arteriosus is regressing, the left one persists. This anomaly is apparently found in the general population in approximately 0.5-1.4% of the cases and in approximately 3% of cases with congenital heart malformations. The present review is focus on the prevalence of aberrant right subclavian artery in Down syndrome. Until present it is known that ultrasound evaluation in the screening programs for Down syndrome is of uncertain value and studies on larger number of cases are reconsidered. In addition we suggest that the echocardiographic examination in the first and second trimesters should be included as a first step of the diagnosis in such congenital anomalies.

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Vasavi Cheguri, Mugdha Kadam, Medha Jain, and Bhavesh Patel. "Right proximal sub-clavian artery pseudoaneurysm masquerading as right upperzone opacity of lung." International Journal of Research in Medical Sciences 11, no. 3 (2023): 1028–30. http://dx.doi.org/10.18203/2320-6012.ijrms20230593.

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Right proximal subclavian artery pseudoaneurysms are uncommon conditions with a relatively small number of recorded instances to date. Such cases might be challenging to diagnose since the patient may have symptoms that are similar to those of other illnesses, including lung cancer. The diagnosis is aided by imaging methods including contrast-enhanced computed tomography (CECT) chest and computed tomography angiography, as well as a high level of clinical suspicion. We present a rare case of a 23-year-old man with no history of lung disease or trauma, who had a complaints of change in voice, difficulty in swallowing and haemoptysis. Right-sided upper zone homogeneous opacity was seen on the chest X-ray. CECT revealed large, well-defined solid cystic areas that extended up to the posterosuperior aspect of the right upper thoracic region. Aneurysm rupture with active contrast leak. Pulmonary angiography revealed the presence of a pseudoaneurysm in the middle mediastinum on the right side, originating from the right proximal subclavian artery. The patient was operated on, and the right subclavian artery and innominate artery pseudoaneurysm were repaired. If subclavian artery pseudoaneurysms are large, they can cause compression symptoms. For compressive symptoms, open surgical resection and vascular reconstruction are required. In a patient with hemoptysis and opacities on chest imaging, arterial aneurysm should be considered as a differential diagnosis alongside lung mass. Before considering a biopsy from the lesion, further evaluation with CECT should be performed.

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Rao, Suresh, and Syam Prasad Darla. "Aberrant Right Subclavian Artery with Retroesophageal Course as a Reason of Dysphagia: A Case Report." Journal of Medicine and Health Research 9, no. 2 (2024): 15–19. http://dx.doi.org/10.56557/jomahr/2024/v9i28880.

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The most prevalent vascular anomaly of the aortic arch is the aberrant right subclavian artery, which is a rare embryological aberration. It is an anatomical variation of the right subclavian artery, emerging as the last branch of aortic arch. A surgical operation involving the esophagus should take this abnormality into account. Any inadvertent damage to this artery while undergoing surgery has a high risk of death. Even though aberrant right subclavian artery can be difficult to treat during an esophagectomy, if it is identified beforehand, careful dissection of the retroesophageal area during the procedure can help avoid damaging the abnormal artery and its related consequences.

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Mohamad Rizki and Heroe Soebroto. "Subclavian artery pseudoaneurysm after penetrating chest trauma: A case report." Intisari Sains Medis 15, no. 2 (2024): 908–11. http://dx.doi.org/10.15562/ism.v15i2.2114.

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Introduction: Subclavian artery pseudoaneurysm is a rare entity with significant mortality and morbidity. Most injuries were related to iatrogenic manipulations, but in some cases, this injury has been described as secondary to a chest trauma. This case report presents a case of a subclavian artery pseudoaneurysm caused by a chest stabbing trauma. Case description: This case is the report of a twenty-four-year-old man with a chief complaint of a painful and pulsating mass on the right shoulder 3 months before admission at the scar on his chest after having penetrating chest trauma; he also complained about weakness on the right arm. An evaluation with thorax MSCT and CT angiography supports the diagnosis of the right subclavian artery pseudoaneurysm. Intraoperative, we found a fistula from the right subclavian artery with hematomas. From the post-operative evaluation, the patient showed motoric improvement in the right arm and no pain. The patient was discharged from the hospital on the ninth day after surgery. Conclusion: Prompt and accurate diagnosis is crucial in subclavian artery pseudoaneurysm for determining the appropriate therapeutic approach, both in surgical preparation and intraoperative focus.

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Tavares, T. G., C. V. B. Lima, L. P. Romão, et al. "Aberrant right subclavian artery in a dog ˗ case report." Arquivo Brasileiro de Medicina Veterinária e Zootecnia 72, no. 6 (2020): 2266–70. http://dx.doi.org/10.1590/1678-4162-12078.

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ABSTRACT The brachiocephalic trunk and the left subclavian artery originate from the aortic arch, and both supply blood to the head, neck, and thoracic limbs. Anatomical variations, such as an aberrant right subclavian artery, are congenital conditions rarely observed in dogs, Thus, the objective of the present report was to describe a case of aberrant right subclavian artery in a 9-year-old Dalmatian. However, this anomaly was a finding in which the patient was asymptomatic during its 9 years of life and only at this age did he exhibit signs including sialorrhea, vomiting, hyporexia, and noisy deglutition. Blood count, biochemical profile, and thoracic radiography led to a diagnosis of megaesophagus and aspiration pneumonia. Despite the recommended treatment, the patient did not respond well; as such, the owner elected to euthanize the animal. On necropsy, the right subclavian artery originated directly from the aortic arch, followed a route from left to right dorsally to the esophagus, and then formed an impression of the vascular path over the muscular wall of the esophagus. The esophagus, in turn, exhibited a flaccid wall and dilation in the caudal portion to the vascular path made by the ectopic position of the right subclavian artery.

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D., Nirmala, and Anjali Gupta. "Variant course of right vertebral artery - a case report." National Journal of Clinical Anatomy 03, no. 04 (2014): 237–39. http://dx.doi.org/10.1055/s-0039-3401767.

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AbstractThe Vertebral artery is the first branch of subclavian artery. It is an important source of blood supply to the brain. During dissection of an adult male cadaver, a unilateral variation in the course of Vertebral artery was found. The right Vertebral artery took origin from the subclavian artery and entered foramen transversarium of fourth cervical vertebra. An understanding of the variability of the Vertebral artery remains most important in angiography & surgical procedures where an incomplete knowledge of its anatomy can lead to complications.

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Brouwer, P. A., M. P. S. Souza, R. Agid, and K. G. terBrugge. "A Five-Vessel Aortic Arch with an Anomalous Origin of Both Vertebral Arteries and an Aberrant Right Subclavian Artery." Interventional Neuroradiology 10, no. 4 (2004): 309–14. http://dx.doi.org/10.1177/159101990401000404.

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In this case presentation we describe a patient with an anomalous origin of the right vertebral artery arising from the right common carotid artery in combination with an aberrant right subclavian artery and a left vertebral artery originating from the arch between the left common carotid artery and left subclavian artery. Hence there were five vessels originating from the aortic arch. The possible embryological mechanism as well as a postulation on the importance of the level of entrance of the vertebral artery in the cervical transverse foramen is discussed.

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Lacroix, Valerie, Parla Astarci, Devaux Philippe, et al. "Endovascular Treatment of an Aneurysmal Aberrant Right Subclavian Artery." Journal of Endovascular Therapy 10, no. 2 (2003): 190–94. http://dx.doi.org/10.1177/152660280301000205.

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Purpose: To describe combined endovascular and surgical management of a complex aneurysmal aberrant right subclavian artery (RSA). Case Report: A 75-year-old obese man with severe chronic obstructive pulmonary disease was referred for treatment of a 6.8-cm aneurysm of an aberrant right subclavian artery. A stent-graft was deployed in the proximal part of the descending aorta to cover the origin of the dilated aberrant RSA, and then a venous carotid-subclavian bypass was made to restore blood flow in the right arm. In a second stage, the prevertebral segment of the aberrant RSA was embolized to avoid retrograde perfusion of the aneurysm. Conclusions: Combined endovascular and surgical treatment of an aneurysmal aberrant subclavian artery is feasible, safe, and effective. This less invasive approach could be the treatment of choice in high-risk patients.

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Kopp, Jason, Ahmad Irshaid, Justin Baker, John Fitzsimmons, and Judith C. Lin. "Aberrant Right Subclavian Artery: Cadaver Case Report." International Journal of Medical Students 10, no. 4 (2023): 413–16. http://dx.doi.org/10.5195/ijms.2022.1647.

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While examining the anatomy of a cadaver in a medical school gross anatomy course, an aortic arch anomaly was discovered. This variant is consistent with an aberrant right subclavian artery (ARSA). In this variant the right subclavian artery branches from the most distal part of the aortic arch and runs both retrotracheal and retroesophageal as it courses to the right shoulder. This variant is a result of aberrant development of the aortic arch and may include presenting symptoms such as dysphagia and shortness of breath, if any at all. Additional to the ARSA exists a common bicarotid trunk and a direct branching of the left vertebral artery from the aortic arch, both of which are rare anomalies. The cadaver’s medical history includes dysphagia and stretched esophagus, although the severity is unknown. This case report draws attention to these rare anatomical anomalies and includes a discussion of the most common clinical presentation, and surgical implications of an aberrant right subclavian artery anomaly.

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Proto, AV, NW Cuthbert, and L. Raider. "Aberrant right subclavian artery: further observations." American Journal of Roentgenology 148, no. 2 (1987): 253–57. http://dx.doi.org/10.2214/ajr.148.2.253.

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Mathieson, SF Silver, and JA Culham. "Isolation of the right subclavian artery." American Journal of Roentgenology 151, no. 4 (1988): 781–82. http://dx.doi.org/10.2214/ajr.151.4.781.

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45

Nath, H. "Isolation of the right subclavian artery." American Journal of Roentgenology 152, no. 2 (1989): 430–31. http://dx.doi.org/10.2214/ajr.152.2.430.

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46

Chapman, Jason R., Shahriar Sedghi, Benjamin D. Christie, Don K. Nakayama, and Julie L. Wynne. "Aberrant Right Subclavian Artery–Esophageal Fistula." American Surgeon 76, no. 12 (2010): 1430–32. http://dx.doi.org/10.1177/000313481007601237.

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47

Baudet, Eugène, Xavier F. Roques, Jean-Philippe Guibaud, Nadine Laborde, and Alain Choussat. "Isolation of the right subclavian artery." Annals of Thoracic Surgery 53, no. 3 (1992): 501–3. http://dx.doi.org/10.1016/0003-4975(92)90278-c.

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48

Al-Badri, Ahmed, and Wael Nasser. "Aberrant Right Subclavian Artery - Esophageal Fistula." Chest 142, no. 4 (2012): 1014A. http://dx.doi.org/10.1378/chest.1386445.

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Mohammed, SallamTaha, MohammedSamir Mokhtar Elwan, and SayedSaid Rabie Mohamed. "Dysphagia lusoria: Aberrant right subclavian artery." Hamdan Medical Journal 14, no. 1 (2021): 39. http://dx.doi.org/10.4103/hmj.hmj_48_20.

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50

Neoh, SH, YY Gan, R. Hardin, Susan W. Matthew, CM Yeat, and D. Balakrishnan. "Management Of Iatrogenic Subclavian Artery Injury Using Balloon Tamponade: A Case Report." IOSR Journal of Nursing and health Science 13, no. 6 (2024): 11–13. http://dx.doi.org/10.9790/1959-1306021113.

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Introduction: Iatrogenic injury to major vessel during central venous catheter insertion is a commonly encountered complication. Different approaches have been described to repair the injured vessel, including open and endovascular technique. Method: We observed a case involving a 47-year-old lady with right subclavian artery injury and hemopneumothorax after insertion of central venous catheter for inotropic support. Result: CT Angiography of the thorax showed malposition of the catheter, piercing the right subclavian artery, with its distal tip within the pleural space at the level of posterior right 7th rib. Digital subtracted angiography (DSA) showed contrast extravasation from proximal right subclavian artery. Temporary balloon tamponade was performed, and the catheter was removed at the same setting. Post balloon tamponade angiogram confirmed no contrast extravasation. Conclusion: Iatrogenic injury to the subclavian artery is rare. Our case demonstrates that the approach of using a balloon to achieve tamponade effect is effective in achieving hemostasis compared to open arterial repair or stenting

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