The Presence of a Right Aortic Arch Associated with Severe Stenosis of the Right Common Carotid Artery and Steal Phenomenon

Stefańczyk, Ludomir; Szymczyk, Konrad; Stefańczyk, Katarzyna; Polguj, Michał

doi:10.1016/j.avsg.2015.05.017

Cited by 6 publications

(5 citation statements)

References 3 publications

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“…Complications associated with a kink or stenosis of the subclavian artery, or aortic pseudocoarctation are less commonly observed [ 12 ]. In the present study, four patients with such abnormalities were detected: two of whom, both women with type II RAA, presented RCCAs which were narrowed by up to 80% at the place of origin, between the aortic arch and sternoclavicular joint.…”

Section: Discussionmentioning

confidence: 99%

“…Another two patients (one woman, one man) were diagnosed with ALSA stenosis of 70% at the level of its origin with poststenotic widening. In literature, such cases are rarely described, but they are nevertheless clinically significant [ 12 – 14 ]. One of the cited cases demonstrates that a right-sided aortic arch with an aberrant subclavian artery can be diagnosed prenatally, and that stenosis of the subclavian artery can occur in early infancy [ 13 ]; the neonatologist or pediatrician should be aware of this, and that stent implantation represents a minimally-invasive therapeutic approach.…”

Section: Discussionmentioning

confidence: 99%

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Right aortic arch analysis – Anatomical variant or serious vascular defect?

Arazińska

Polguj

Szymczyk

et al. 2017

BMC Cardiovasc Disord

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BackgroundThe right-sided aortic arch (RAA) is a rare congenital defect of the aorta. The aim of the study was to assess the occurrence of RAA in diagnoses performed by the University Radiology Department and analyze the frequency of concomitant vascular abnormalities.MethodsThe database of the Radiology Department was retrospectively analyzed between January 2008 and May 2016 with the keyword “right aortic arch”. Twenty patients with this diagnosis were identified from a total of 11,690 CT examinations of the chest area, 19,623 CT examinations of brain-supplying vessels, and 1863 MRI examinations of the heart and aortic arch or brain-supplying arteries. The type of aortic arch, the occurrence of Kommerell’s diverticulum and possible other vascular abnormalities, such as stenosis, kinking or occlusion, were then investigated.ResultsThe analysis identified nine patients with type I and 11 patients with type II RAA. Eight of the 11 type II patients presented Kommerell’s diverticulum. Concomitant vascular abnormalities were detected in four patients with type II RAA. In two cases, the right common carotid artery (RCCA) was narrowed by up to 80%, with steal phenomenon confirmed in one of them. In the second coincident right subclavian artery (RSA) stenosis was depicted. In two other cases, the aberrant left subclavian arteries (ALSA) were found to be narrowed at the level of origin by up to 70%. One patient was found with type B aortic dissection including ALSA and Kommerell’s diverticulum.ConclusionsOur observations indicate that concomitant vascular abnormalities may occur more often than reported in literature. Patients diagnosed with type II RAA should be examined with Doppler ultrasonography to identify coincident vascular disorders, especially stenosis of the common carotid arteries or subclavian arteries.Electronic supplementary materialThe online version of this article (doi:10.1186/s12872-017-0536-z) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Right aortic arch analysis – Anatomical variant or serious vascular defect?

Arazińska

Polguj

Szymczyk

et al. 2017

BMC Cardiovasc Disord

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“…It may also present as subclavian steal syndrome with symptoms of vertebro-basilar insufficiency as a result of retrograde flow in the ipsilateral vertebral artery [3] . The most common cause of subclavian artery stenosis is atherosclerosis but other causes include congenital abnormalities such as arteria lusoria (aberrant subclavian artery) or right sided aortic arch that can cause compression of the right subclavian artery leading to congenital subclavian steal syndrome [4] , [5] , [6] .…”

Section: Introductionmentioning

confidence: 99%

Treatment of subclavian artery stenosis: A case series

Salman

Hornsby

Wright

et al. 2016

International Journal of Surgery Case Reports

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HighlightsCase presentation of a patient treated with subclavian artery stenting.Case presentation of a patient treated with transposition of the left subclavian artery onto the left common carotid artery.Case presentation of a patient treated with carotid- subclavian artery bypass with a PTFE graft.Case presentation of a patient treated with carotid to axillary bypass.Discussion and literature review of methods and indications of treatment of subclavian artery occlusive disease.

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“…[ 22 ] One with cerebrovascular insufficiency is caused by severe right CCA stenosis and steal phenomena. [ 19 ] The other case was pseudo-occlusion of the left ICA. [ 14 ] We report a case of anterior circulation insufficiency due to symptomatic left CCA and ICA stenosis (30–50%) causing the patient’s symptoms.…”

Section: Discussionmentioning

confidence: 99%

Right-sided aortic arch with complex anomalies presented with transient ischemic attack

Al-Khazaali

Hummadi

Ismail

et al. 2022

Surgical Neurology International

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Background: The right-sided aortic arch (RAA) is an uncommon anatomical anomaly found in <0.1% of the adult population. In this article, we report a case of RAA anomaly with an aberrant left subclavian artery (ALSA) and Kommerell’s diverticulum associated with aneurysmal dilation of the ascending aorta, left carotid artery (CCA) stenosis, and pancake kidney presented with a transient ischemic attack (TIA). To the best of our knowledge, this is the first case in the literature that discusses such associations, especially in a symptomatic patient with neurological rather than tracheaesophageal symptoms and in the absence of the steal phenomenon. Case Description: A 52-year-old male, with a history of recurrent multiple TIAs, presented immediately after the onset of blurred vision and left-sided weakness. The initial diagnostic cerebral angiogram revealed a left CCA stenosis of <30%, with normal posterior circulation vasculature. The diagnosis of RAA was made with computed tomography angiography (CTA) of the thoracic and abdominal aorta, which revealed Type 2 RAA, with ALSA, which had a bullous dilatation at its origin that suggests Kommerell’s diverticulum. Another two findings on CTA were a persistent left-sided superior vena cava that ended in the coronary sinus and a single pelvic fused renal mass (Pancake kidney). Conclusion: We presented an extremely rare case of RAA with ALSA associated with a group of extra rare anomalies. Understanding the anatomical variants of RAA and its characteristics is critical to improving the management and follow-up of patients with such anomalies.

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The Presence of a Right Aortic Arch Associated with Severe Stenosis of the Right Common Carotid Artery and Steal Phenomenon

Cited by 6 publications

References 3 publications

Right aortic arch analysis – Anatomical variant or serious vascular defect?

Right aortic arch analysis – Anatomical variant or serious vascular defect?

Treatment of subclavian artery stenosis: A case series

Right-sided aortic arch with complex anomalies presented with transient ischemic attack

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