Morphological Aspects of the Aberrant Right Subclavian Artery—A Systematic Review of the Literature

Abstract

Background: The aberrant origin of the right subclavian artery (ARSA), also known as the lusoria artery, is a congenital malformation with an incidence of 0.5–4.4%. Most cases are incidental due to minimal clinical manifestations. Computer tomography (CT) is important in diagnosing and evaluating these patients. Materials and Methods: We conduct a computerized search in two databases, PubMed and EMBASE, for articles published between 1 January 2022 and 31 December 2023, PROSPERO code: CRD42024511791. Eligible for inclusion were case reports and case series that presented the aberrant origin of the right subclavian artery. The main outcome was the highlighting of the morphological types of ARSA. In this context, we proposed a new classification system of this anomaly. The secondary outcome was the evaluation of the demographic distribution of the lusoria artery. Results: Our search identified 47 articles describing 51 patients with ARSA. The typical course for ARSA is retroesophageal, being registered in 49 out of 51 patients. This malformation is frequently associated with Kommerell diverticulum (15 out of 51), troncus bicaroticus (7 out of 51), and aberrant origins of the right vertebral artery (7 out of 51). We observed a higher incidence of the condition among women (32 out of 51) compared to men (19 out of 51). From a demographic point of view, ARSA is more frequent in the “44 to 57 years” and “58 to 71 years” age ranges. Conclusions: ARSA is a congenital malformation resulting from a defect in the development of the aortic arches. The imaging studies such as computer tomography play a defined diagnostic role.

Hybrid Management of Dysphagia Lusoria with Tevar Implantation and Bilateral Subclavian Arteries Debranching: A Review of the Literature and a Case Report

“…“Dysphagia lusoria”, also known as Bayford syndrome, was first introduced by David Bayford in 1794 and describes an extrinsic compression of the esophagus caused by a vascular anomaly of the aortic arch [ 1 ]. The most frequent embryologic abnormality of the aortic arch is an aberrant right subclavian artery (ARSA) [ 2 ].…”

Medical–Surgical Implications of Branching Variation of Human Aortic Arch Known as Bovine Aortic Arch (BAA)

“…In most cases, the fifth arch regresses completely, but rarely may it form the double-barrel aorta. The sixth arch becomes part of the pulmonary arteries and ductus arteriosus [6,7].…”

“…In most cases, these arteries branch into the subclavian arteries, but sometimes they can derive directly from the AA or the common carotid arteries [7]. The most common branching variation of the left AA is the bovine aortic arch (BAA), with a prevalence ranging from 7% to 25% [10][11][12][13].…”