Involvement of an aberrant right subclavian artery in dissection of the thoracic aorta: diagnostic and therapeutic implications

Weinberger, Gerald; Pa, Randall; Fb, Parker; Sa, Kieffer

doi:10.2214/ajr.129.4.653

Cited by 31 publications

(11 citation statements)

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“…[6][7][8] The aberrant subclavian artery may also be involved in aortic dissection, 9,10 as seen in this report.…”

Section: Discussionsupporting

confidence: 59%

Aortic dissection originating from an aberrant right subclavian artery

Zhang

2007

Journal of Vascular Surgery

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A 47-year-old male patient presented with aortic dissection originating from an aberrant right subclavian artery. Intraoperative arteriography showed an anomaly of the aortic arch including a common carotid trunk and an aberrant right subclavian artery. An intimal tear was located in the aberrant right subclavian artery. Dissection retrogradely involved the aortic arch and then anterogradely involved the distal aorta. We treated the patient endovascularly with a Wallgraft endoprosthesis deployed in the aberrant right subclavian artery to seal the entry site. Follow-up computed tomography showed a satisfactory healing process with complete thrombosis in the proximal part of the false lumen.

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“…[6][7][8] The aberrant subclavian artery may also be involved in aortic dissection, 9,10 as seen in this report.…”

Section: Discussionsupporting

confidence: 59%

Aortic dissection originating from an aberrant right subclavian artery

Zhang

2007

Journal of Vascular Surgery

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“…The general prevalence of an RRSA var ies between 1 and 2% according to different authors [Holzapfel, 1899;Cairney, 1925;Adachi, 1928;Orts Llorca, 1936a, b;Pattinson, 1953;Nathan and Gitlin, 1968;Weinberger et al, 1977;Lam ct al., 1978]. Gross and Ware [1946] estimate their find ings as 0.4% in dissecting rooms, and 1,6% during autopsies.…”

Section: Discussionmentioning

confidence: 99%

“…Aneurysms of the RRSA were described by various authors : Schmidt et al [1980] recently described a case of RRSA aneurysm manifested by small arte rial emboli to the hands and digits. Cases of dissecting aneurysms of the thoracic aorta extending to the RRSA are also mentioned [Syme, 1972;Weinberger el al., 1977], with some having perforated into the esophagus [ Weinberger et al. 1977].…”

Section: Discussionmentioning

confidence: 99%

“…The defect may be seen pulsating [Felson et al, 1950). An RRSA was also found to be a cause of cerebral circulatory failure [Skiora et al, 1978;Wackenheim and Kleinclaus, 1979], Surgical interventions are often per formed on an RRSA which is producing symptoms [ Cross and Ware, 1946;Gross and Neahauser, 1951;Blalock, 1948;Vidne et al, 1972;Lemire et al, 1977;Weinberger et al, 1977;Jung et al, 1978;Lam et al. Clmffin et al.…”

Section: Discussionmentioning

confidence: 99%

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The Association of a Retroesophageal Right Subclavian Artery, a Right-Sided Terminating Thoracic Duct, and a Left Vertebral Artery of Aortic Origin: Anatomical and Clinical Considerations

Nathan

Seidel²

1983

Cells Tissues Organs

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The findings in a cadaver demonstrated: (a) an aberrant retroesophageal right subclavian artery (RRSA); (b) a thoracic duct (Th.d.) terminating at the junction of the right internal jugular and subclavian veins (‘venous angle’), and (c) a left vertebral artery (LVA) of aortic origin. The origin of the RRSA from the aortic arch was distal and medial to the left subclavian artery and it reached the upper extremity by crossing posterior to the esophagus. The Th.d. ran a normal retroesophageal course in the mediastinum, until it was intercepted by the anomalous subclavian artery. At this level the Th.d. was deflected towards the right and, accompanied by the anomalous artery, reached the right venous angle. The LVA arose from the aortic arch between the left common carotid and the left subclavian arteries, and ascended to the transverse foramen of C6. The practical importance of associations in general is discussed, and the special diagnostic and surgical significance of the RRSA and Th.d. is stressed.

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“…This was true in 59 limbs (98.33%) of the present study except in one (3.33%), where RRSA was found. Such an artery has been encountered in the past by various workers in the prevalence range of 0.4 -2% (5)(6)(7)(8)(9)(10)(11) .…”

Section: Discussionmentioning

confidence: 99%

Anatomical Considerations and Clinical Implications of Subclavian Artery

Poonam¹,

Jyoti²,

Singla³

et al. 2013

jemds

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AIMS:The knowledge of normal and variant anatomy of subclavian artery in terms of its origin, dimensions, course and relations is mandatory in various diagnostic, interventional and surgical procedures. This study was conducted to aware the surgeon for possible variations in this region and their clinical significance. MATERIAL AND METHODS: 60 subclavian arteries belonging to 30 cadavers were dissected. Various parameters were studied regarding subclavian artery. Site and mode of origin , level of origin, diameter at its origin and termination, length of subclavian arteries, maximum distance coursed by artery above clavicle and its relations. RESULTS: In one specimen, anomalous origin of right subclavian artery was encountered. High arched subclavian were noted in another specimen with deviated course and arching close to pleural apex. Level of origin on left side was constant while right side showed variability. Mean values of morphological measurements were calculated. Relation with vagus and phrenic nerves were found to be normal. CONCLUSION: Knowledge of variant anatomy of subclavian artery must be kept in mind while performing surgeries on head and neck and upper thorax. Less critical knowledge of anatomy of the subclavian artery would lead to troublesome complications. INTRODUCTION:In anatomy, normality embraces a range of morphologies. It includes those that are most common and others called "variations" which are less frequent but not considered abnormal. These variations ranging from subtle to remarkable affect every part of the human body. They may have important influences on predisposition to illness, symptomatology, clinical examination, investigation and patient management including operative surgery. Recognition of variations enables clinicians to distinguish features which merit further investigations or treatment from those which do not 1 .Subclavian artery is the major artery supplying upper limb, thorax, head and neck and brain. Origin of subclavian artery is different on right and left sides. On right side it arises from brachiocephalic trunk behind the right sternoclavicular joint and on left side from aortic arch in superior mediastinum and passes into root of neck. In the root of neck each artery arches across the dome of pleura behind the scalenus anterior muscle which divides it into three parts viz. first, second and third part 2, 3, 4 . The extent to which the artery rises above the clavicle varies from 1.2 to 2.5 cm 2 .Variations in origin, course and relations of subclavian arteries are not infrequent and many of these have been furnished earlier in literature. Right subclavian artery may arise above or below sternoclavicular level; it may be a separate branch coming directly as the first or last branch of the aortic arch. When first, it is in the position of the brachiocephalic trunk and when last it arises from arch's left end, ascending obliquely to the right behind the trachea, oesophagus and right common carotid to the first rib. Left subclavian is occasionally combine...

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Involvement of an aberrant right subclavian artery in dissection of the thoracic aorta: diagnostic and therapeutic implications

Cited by 31 publications

References 0 publications

Aortic dissection originating from an aberrant right subclavian artery

Aortic dissection originating from an aberrant right subclavian artery

The Association of a Retroesophageal Right Subclavian Artery, a Right-Sided Terminating Thoracic Duct, and a Left Vertebral Artery of Aortic Origin: Anatomical and Clinical Considerations

Anatomical Considerations and Clinical Implications of Subclavian Artery

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