Arteria lusoria: Developmental anatomy, clinical, radiological and surgical aspects

Myers, Patrick Olivier; Fasel, Jean; Kalangos, Afksendiyos; Gailloud, Philippe

doi:10.1016/j.ancard.2009.07.008

Cited by 130 publications

(154 citation statements)

References 43 publications

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“…The reason for this late presentation is that vessels are soft and compliant in children and young adults, while later in life, especially in those with chronic conditions like diabetes and hypertension (as seen in our patient), arteries become rigid and even aneurysmal and may cause compression of a structure like the esophagus more easily (5). In the absence of an aneurysm of the aberrant artery, the combination of a bicarotid trunk anteriorly and a retroesophageal ARSA entrapping the esophagus (as seen in the present case) are believed to be associated to symptoms of dysphagia more frequently (5).…”

Section: Discussionmentioning

confidence: 89%

Hybrid treatment of dysphagia lusoria: right carotid to subclavian bypass and endovascular insertion of an Amplatzer II Vascular Plug

Cobos-González¹,

Aragón-López²,

García-Buen-Abad³

et al. 2016

Rev Esp Enferm Dig

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Compression of the esophagus by a retroesophageal aberrant right subclavian artery (ARSA) is a rare cause of dysphagia. We present the case of a 47-year-old female with symptoms of progressive dysphagia diagnosed with dysphagia lusoria using barium swallow and contrast computed tomography and successfully treated with a hybrid procedure: right carotid to subclavian bypass and endovascular insertion of an Amplatzer II Vascular Plug through the right superficial femoral artery. We consider this approach safer, less invasive and more complete to avoid recurrent dysphagia.

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Section: Discussionmentioning

confidence: 89%

Hybrid treatment of dysphagia lusoria: right carotid to subclavian bypass and endovascular insertion of an Amplatzer II Vascular Plug

Cobos-González¹,

Aragón-López²,

García-Buen-Abad³

et al. 2016

Rev Esp Enferm Dig

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“…La ASI puede ser atada a la aorta descendente por un pequeño segmento que puede presentar una dilatación aneurismal conocida por el divertículo de Kommerell 1 . Una arteria subclavia aberrante izquierda puede ser observada con un arco aórtico derecho realizando una imagen en espejo 1 .…”

Section: Discussionunclassified

“…Sin embargo y en la edad pediátrica, predominan los signos respiratorios como la disnea, el estridor, la tos crónica, los episodios de cianosis, las infecciones bronquiales 19 . También, la AL puede estar sintomá-tica en caso de la existencia de un aneurisma y en adultos que presentan ateroesclerosis o displasia arterial fibromuscular 1,19 .…”

Section: Discussionunclassified

Hallazgo de arteria lusoria en el estudio de otitis media a repetición: A propósito de una observación pediátrica y revista breve de la literatura

Idir¹

2017

Rev. Otorrinolaringol. Cir. Cabeza Cuello

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“…1 In 1794, Bayford described the association between the postmortem diagnosis of an ARSA with patients' symptoms and named this condition ''dysphagia lusoria'' from lusus naturae, like a freak of nature. 2 Embryologically, the proximal part of the right subclavian artery normally originates from the fourth right aortic arch.…”

Section: Discussionmentioning

confidence: 99%

“…Other symptoms described are interscapular pain, cough, hematemesis, and dyspnea. 1 Barium contrast examination of the esophagus is a good diagnostic tool, demonstrating a characteristic impression defect at the level of the third and fourth vertebra 5 ; CTA and/or angiography usually are the best examinations to confirm the diagnosis. 5 Due to the rarity of this condition, indications for surgical intervention have been described, but not fully agreed upon.…”

Section: E10 Case Reportsmentioning

confidence: 99%

Mediastinoscopy-assisted Treatment of an Aberrant Right Subclavian Artery

Varetto

Castagno

Trevisan

et al. 2016

Annals of Vascular Surgery

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Aberrant right subclavian artery (ARSA) is a rare congenital anomaly characterized by the origin of the right subclavian artery from the aortic arch distally to the left subclavian artery. We describe the case of a young patient with symptomatic ARSA treated by mediastinoscopyassisted ligation at its origin and subclavianecarotid transposition.The aberrant right subclavian artery (ARSA) is a rare congenital anomaly characterized by a retroesophageal course of the right subclavian artery, whose origin from the aortic arch is distal to the left subclavian artery. The majority of patients with ARSA are asymptomatic; however, this anomaly may cause a condition named dysphagia lusoria. CASE REPORTA 36-year-old woman was referred to our center for a history of progressively worsening dysphagia and severe loss of weight. The patient reported an initial dysphagia for solids which had started 2 months prior. This has recently progressed to a dysphagia for liquids as well. Both neurological and otolaryngology evaluations were negative for organic or functional swallowing impairments. Due to her malnourished conditions, parental nutrition was administered. Videofluoroscopy was then performed and demonstrated an external compression during bolus progression in the proximal zone of esophagus on the anterolateral left side of the esophagus. This finding was considered highly suggestive for an ARSA. A computed tomography angiography (CTA) confirmed the diagnosis of an 8-mm ARSA and also revealed the associated anomalous origin of the left common carotid artery from the innominate trunk (Fig. 1). Due to the significant symptoms, surgical intervention was then planned. Under general anesthesia, the patient was placed in the supine position. A sandbag was positioned in the midline behind her shoulders to achieve a better extension of the neck. Through a 6 cm right supraclavicular incision, we sectioned the clavicular head of the sternocleidomastoid muscle and the anterior scalene muscle, after identification of the phrenic nerve. This helped to expose the ARSA, the mammary artery, the thyreocervical trunk, and the right vertebral artery. Then, with the use of a mediastinoscope, we followed the proximal aberrant subclavian artery in the retroesophageal space until 1 cm from its origin off the aortic arch. After systemic heparinization, a curved Satinsky vascular clamp was placed at the origin of ARSA (Fig. 2A); then, we oversewed the proximal portion of this artery as close to its origin as possible with a 2 Mersilene suture and transected it. The distal portion of the right subclavian artery was trimmed and with a careful preservation of the right vertebral artery, an end-to-side anastomosis was made with the right common carotid artery with a polypropylene 6-0 (Fig. 2B). No intraoperative complications occurred. Her postoperative course was uneventful and she tolerated regular diet with immediate regression of her dysphagia. On second postoperative day, a Gastrografin transit confirmed the absence of any obstruction in the esoph...

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Arteria lusoria: Developmental anatomy, clinical, radiological and surgical aspects

Cited by 130 publications

References 43 publications

Hybrid treatment of dysphagia lusoria: right carotid to subclavian bypass and endovascular insertion of an Amplatzer II Vascular Plug

Hybrid treatment of dysphagia lusoria: right carotid to subclavian bypass and endovascular insertion of an Amplatzer II Vascular Plug

Hallazgo de arteria lusoria en el estudio de otitis media a repetición: A propósito de una observación pediátrica y revista breve de la literatura

Mediastinoscopy-assisted Treatment of an Aberrant Right Subclavian Artery

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