Aberrant right subclavian artery (ARSA) in unselected population at first and second trimester ultrasonography

Rembouskos, G.; Passamonti, Ubaldo; Robertis, V. De; Tempesta, A.; Campobasso, G.; Volpe, G.; Gentile, Mattia; Volpe, P.

doi:10.1002/pd.3942

Cited by 58 publications

(104 citation statements)

References 26 publications

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“…On the contrary, Chaoui et al [2] reported 5 cases of trisomy 21 having ARSA, and in 1 (20%) of them ARSA was the only positive sonographic marker. Similarly, Rembouskos et al [10] reported 6 cases of ARSA with trisomy 21 in 1 (16.6%) of which ARSA was isolated. Furthermore, in the series with 8 fetuses with ARSA and Down syndrome, Borenstein et al [5] reported that only 1 fetus (12.5%) had ARSA as an isolated finding.…”

Section: Discussionmentioning

confidence: 99%

“…However, whether ARSA can be used as an isolated marker of Down syndrome, or only in combination with cardiac or extracardiac sonographic findings is yet to be established. Some of the previous studies showed the presence of trisomy 21 in cases with isolated ARSA [2,9,10,11], while in the other studies ARSA was associated with another sonographic finding in all cases with a chromosomal anomaly [4,6,12]. Moreover, the estimated likelihood ratio of isolated ARSA for Down syndrome was reported as 3.94 in a meta-analysis [8].…”

Section: Introductionmentioning

confidence: 99%

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Detection Rate of Trisomy 21 in Fetuses with Isolated and Non-Isolated Aberrant Right Subclavian Artery

Esmer

Gül²,

Nehir

et al. 2013

Fetal Diagn Ther

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Objective: The purpose of this study was to determine the frequency of chromosomal anomalies among the fetuses with isolated and non-isolated aberrant right subclavian artery (ARSA), and to evaluate the sonographic findings associated with ARSA. Methods: This is a retrospective study conducted during the period between January 2008 and December 2012 at the maternal fetal medicine units of three different referral centers. Results: Among the 148 cases of ARSA, 98 were isolated and 50 were associated with cardiac anomalies, extracardiac malformations or soft markers. Trisomy 21 was the only chromosomal anomaly with a prevalence of 6.8% (10/148). The corresponding rate was 6.1% (6/98) and 8% (4/50) for isolated and non-isolated ARSA, respectively. Cardiac anomalies, extracardiac findings and soft markers were detected in 5.4% (8), 10.8% (16) and 24.3% (36) of cases, respectively. Among the 10 fetuses with trisomy 21, 6 were isolated, 4 were associated with soft markers, 2 were associated with fetal growth restriction and 1 was associated with hydrops fetalis. Cardiac anomalies were not observed in any of these fetuses. Conclusion: The prenatal diagnosis of ARSA should prompt meticulous anatomic survey, and karyotype analysis might be offered even in the absence of associated findings.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Detection Rate of Trisomy 21 in Fetuses with Isolated and Non-Isolated Aberrant Right Subclavian Artery

Esmer

Gül²,

Nehir

et al. 2013

Fetal Diagn Ther

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“…Em conclusão, além de podermos afirmar que é possível a identificação de ARSA no primeiro trimestre, pensamos que a avaliação da artéria subclávia direita no feto é de grande importância pelas seguintes razões, de acordo com literatura recente 4,8,18 : fetos com ARSA têm maior risco de apresentarem cariótipo anormal 11,13,18 ; fetos com ARSA têm maior probabilidade de terem cardiopatias congênitas (mesmo os cromossomicamente normais) 4,14,18 ; ARSA pode ser o único marcador isolado em fetos com trissomia 21 4,8,18 -na nossa opinião, a curva de aprendizagem para avaliação da artéria subclávia direita para ecografistas com experiência em diagnóstico pré-natal é rápida e fácil (poderá ser realizado um estudo para contabilizar quantos exames ecográficos serão necessários até a aprendizagem da avaliação da artéria subclávia direita); é um marcador de avaliação exequível no primeiro trimestre e principalmente no 2º trimestre (em >95% dos casos é possível a sua avaliação) 8,18 ; não aumenta em demasia a duração do exame ecográfico (<2 minutos).…”

Section: Discussionunclassified

Avaliação da artéria subclávia direita na ecografia do primeiro trimestre

Verde¹,

Braga²,

Gonçalves³

et al. 2015

Rev. Bras. Ginecol. Obstet.

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Resumo OBJETIVO: Avaliar a artéria subclávia direita durante a ecografia do primeiro trimestre, descrever a técnica para a sua avaliação e, em caso de identificação de artéria subclávia direita aberrante (ARSA), determinar sua associação com alterações cromossómicas e/ou malformações cardíacas e sua orientação. MÉTODOS: Estudo prospectivo que consistiu na avaliação da artéria subclávia direita no primeiro trimestre (comprimento crânio caudal entre 45 e 84 milímetros), em todas as gestações únicas, consecutivas, por um único examinador, ecógrafo Voluson E8 (GE Healthcare, Zipf, Áustria) com sonda transabdominal RAB 4-8-D, 2 a 8 MHz, por um período não superior a 2 minutos, numa população geral de baixo risco. Com a ajuda do power/color Doppler, a artéria subclávia direita foi classificada como normal ou aberrante. Foi utilizada análise de regressão estatística (IBM SPSS Statistics for Windows, versão 20.0) para estudar o grau de associação entre a falha na avaliação/ classificação da artéria subclávia direita e o comprimento crânio-caudal fetal e o índice de massa corporal materno. RESULTADOS: A mediana da idade materna foi de 30 anos (variando entre 17 e 43 anos) e a mediana do tempo de gestação no momento da avaliação da artéria subclávia direita foi de 12 semanas de gestação (variando entre 11 e 13 semanas de gestação). A avaliação da artéria subclávia direita foi possível em 138/176 (78,4%) dos casos. ARSA foi diagnosticada em um único caso (0,7%). Esse feto com ARSA também apresentou um foco hiperecogênico no ventrículo cardíaco esquerdo. Foi realizada ecocardiografia fetal às 16 semanas de gestação, que confirmou o diagnóstico de ARSA e foco hiperecogênico. A amniocentese revelou cariótipo normal, 46, XX. CONCLUSÃO: É possível fazer o diagnóstico de ARSA na ecografia do primeiro trimestre. O nosso único caso de ARSA apresentou um cariótipo normal sem malformações cardíacas associadas. Abstract PURPOSE:To determine the feasibility of evaluation of the right subclavian artery during the first trimester ultrasound scan, as well as to describe the technique for its evaluation and, in case of aberrant right subclavian artery (ARSA) identification, to determine its association with chromosomal abnormalities and/or cardiac malformations and its management. METHODS: A prospective study for evaluation of the right subclavian artery during the first trimester ultrasound scan (crownto-rump length between 45 and 84 mm), in all consecutive single pregnancies, by a single examiner, using a Voluson E8 system (GE Healthcare, Zipf, Austria) with a 2 to 8 MHz RAB 4-8-D transabdominal probe, within a short period of time (less than 2 minutes), in a general low risk population. Color and/or power Doppler flow mapping was used to classify the right subclavian artery as normal or aberrant. Regression analysis with the IBM SPSS Statistics software for Windows, version 20.0 was used to determine the significance of the association between failure to examine/classify the right subclavian artery and both fetal crown-rump length and ...

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“…Most references say that to identify we must perform an axial view with color-Doppler at the three-vessels level and then swing the probe upwards to the right fetal shoulder [12][13][14].…”

Section: Prenatal Ultrasound Diagnosismentioning

confidence: 99%

Assessesment of Subclavian Arteries: Usefulness of Coronal View in Prenatal Ultrasound Diagnosis

Savirón-Cornudella¹,

D²,

Corona³

et al. 2017

J Integr Cardiol

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The axial view is the reference for the diagnosis of vascular anomalies, including affecting subclavian arteries, like the aberrant right subclavian artery (ARSA) or an aberrant left subclavian artery (ALSA). Although axial view allows us to distinguish vascular subclavian arteries anomalies in most cases, we can use the coronal view not only in cases of ARSA but also in cases of ALSA using the same methodology. Therefore, we can say that coronal view help us as an additional aid to support the diagnosis of both vascular anomalies.

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Aberrant right subclavian artery (ARSA) in unselected population at first and second trimester ultrasonography

Cited by 58 publications

References 26 publications

Detection Rate of Trisomy 21 in Fetuses with Isolated and Non-Isolated Aberrant Right Subclavian Artery

Detection Rate of Trisomy 21 in Fetuses with Isolated and Non-Isolated Aberrant Right Subclavian Artery

Avaliação da artéria subclávia direita na ecografia do primeiro trimestre

Assessesment of Subclavian Arteries: Usefulness of Coronal View in Prenatal Ultrasound Diagnosis

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