open access

Vol 82, No 3 (2023)
Case report
Submitted: 2022-07-14
Accepted: 2022-09-26
Published online: 2022-09-30
Get Citation

An aberrant right subclavian artery in a 63-year-old male cadaver

P. Ostrowski1, M. Bonczar1, W. Przybycień1, I. Zamojska1, B. Kołodziejczyk1, J. Walocha1, M. Koziej1
·
Pubmed: 36178279
·
Folia Morphol 2023;82(3):726-731.
Affiliations
  1. Department of Anatomy, Jagiellonian University Medical College, Krakow, Poland

open access

Vol 82, No 3 (2023)
CASE REPORTS
Submitted: 2022-07-14
Accepted: 2022-09-26
Published online: 2022-09-30

Abstract

An aberrant right subclavian artery (ARSA), also called “arteria lusoria”, is described
as a right subclavian artery (RSA) with a retro-oesophageal course that most
frequently originates as the most distal branch of the aortic arch. The aim of the
following study was to present and thoroughly describe a case of an ARSA, its
course, branches, and relation to the surrounding anatomical structures and discuss
the clinical significance and embryology of this variant. During routine dissection,
a 63-year-old male cadaver with an abnormal variant of the RSA was found. The
RSA branched off from the aortic arch as the most distal branch. Subsequently,
it coursed posteriorly to the trachea and oesophagus at the level of T2 and T3.
Abnormalities in the branching pattern of the RSA were also discovered, such as
the right vertebral artery originating from the right common carotid artery as its
first branch. This study presents a case of an ARSA, which is a rare anatomical
variant of the branches of the aortic arch. The course and branching pattern of
an aberrant subclavian artery is quite variable, and each variant can be associated
with different possible complications. Furthermore, the ARSA is associated with
other cardiovascular anomalies, such as the Kommerell’s diverticulum. Therefore,
knowledge about the possible variations of this anomaly may be of great importance
for physicians who encounter this variant in their practice.

Abstract

An aberrant right subclavian artery (ARSA), also called “arteria lusoria”, is described
as a right subclavian artery (RSA) with a retro-oesophageal course that most
frequently originates as the most distal branch of the aortic arch. The aim of the
following study was to present and thoroughly describe a case of an ARSA, its
course, branches, and relation to the surrounding anatomical structures and discuss
the clinical significance and embryology of this variant. During routine dissection,
a 63-year-old male cadaver with an abnormal variant of the RSA was found. The
RSA branched off from the aortic arch as the most distal branch. Subsequently,
it coursed posteriorly to the trachea and oesophagus at the level of T2 and T3.
Abnormalities in the branching pattern of the RSA were also discovered, such as
the right vertebral artery originating from the right common carotid artery as its
first branch. This study presents a case of an ARSA, which is a rare anatomical
variant of the branches of the aortic arch. The course and branching pattern of
an aberrant subclavian artery is quite variable, and each variant can be associated
with different possible complications. Furthermore, the ARSA is associated with
other cardiovascular anomalies, such as the Kommerell’s diverticulum. Therefore,
knowledge about the possible variations of this anomaly may be of great importance
for physicians who encounter this variant in their practice.

Get Citation

Keywords

subclavian artery, aberrant right subclavian artery, arteria lusoria

About this article
Title

An aberrant right subclavian artery in a 63-year-old male cadaver

Journal

Folia Morphologica

Issue

Vol 82, No 3 (2023)

Article type

Case report

Pages

726-731

Published online

2022-09-30

Page views

1104

Article views/downloads

838

DOI

10.5603/FM.a2022.0085

Pubmed

36178279

Bibliographic record

Folia Morphol 2023;82(3):726-731.

Keywords

subclavian artery
aberrant right subclavian artery
arteria lusoria

Authors

P. Ostrowski
M. Bonczar
W. Przybycień
I. Zamojska
B. Kołodziejczyk
J. Walocha
M. Koziej

References (31)
  1. Alghamdi MA, Al-Eitan LN, Elsy B, et al. Aberrant right subclavian artery in a cadaver: a case report of an aortic arch anomaly. Folia Morphol. 2021; 80(3): 726–729.
  2. Backer CL, Ilbawi MN, Idriss FS, et al. Vascular anomalies causing tracheoesophageal compression. Review of experience in children. J Thorac Cardiovasc Surg. 1989; 97(5): 725–731.
  3. Bayford D. An Account of a Singular Case of Obstructed Deglutition. Memoirs of the Medical Society of London, London 1787.
  4. Bonczar M, Ostrowski P, Dziedzic M, et al. The costocervical trunk: A detailed review. Clin Anat. 2022; 35(8): 1130–1137.
  5. Fehmi Yazıcıoğlu H, Sevket O, Akın H, et al. Aberrant right subclavian artery in Down syndrome fetuses. Prenat Diagn. 2013; 33(3): 209–213.
  6. Gross RE. Surgical treatment for dysphagia lusoria. Ann Surg. 1946; 124(3): 532–534.
  7. Hanneman K, Newman B, Chan F. Congenital variants and anomalies of the aortic arch. Radiographics. 2017; 37(1): 32–51.
  8. Hanneman K, Newman B, Chan F. Congenital variants and anomalies of the aortic arch. Radiographics. 2017; 37(1): 32–51.
  9. Hunauld PM. Examen de quelques parties d’un singe. Histoire de l’Academie Royale des Sciences. 1735; 2: 516–523.
  10. Iwanaga J, Singh V, Ohtsuka A, et al. Acknowledging the use of human cadaveric tissues in research papers: Recommendations from anatomical journal editors. Clin Anat. 2021; 34(1): 2–4.
  11. Kahn C, MacNeil M, Fanola C, et al. Complex arterial patterning in an anatomical donor. Transl Res Anat. 2018; 12: 11–19.
  12. Kieffer E, Bahnini A, Koskas F. Aberrant subclavian artery: surgical treatment in thirty-three adult patients. J Vasc Surg. 1994; 19(1): 100–110.
  13. Kommerell B. Verlagerung des ösophagus durch eine abnorm verlaufende arteria subclavia dextra (arteria lusoria). Fortschr Geb Roentgenstr. 1936; 54: 590–595.
  14. Leon M, Garibaldi M, Virgen F, et al. Hybrid treatment of aberrant right subclavian artery causing dysphagia lusoria by subclavian to carotid transposition and endovascular plug. Vasc Specialist Int. 2020; 36(4): 258–262.
  15. Mishra A, Sah B, Yadav R, et al. Five vascular variations in a male cadaver: An anatomical case report. Transl Res Anat. 2022; 28: 100208.
  16. Molz G, Burri B. Aberrant subclavian artery (arteria lusoria): sex differences in the prevalence of various forms of the malformation. Evaluation of 1378 observations. Virchows Arch A Pathol Anat Histol. 1978; 380(4): 303–315.
  17. Moore KL, Dalley AF, Agur A. Clinically oriented anatomy. 8th ed. Lippincott Williams and Wilkins 2017.
  18. Morris ME, Benjamin M, Gardner GP, et al. The use of the Amplatzer plug to treat dysphagia lusoria caused by an aberrant right subclavian artery. Ann Vasc Surg. 2010; 24(3): 416.e5–416.e8.
  19. Nakajima Y, Nishibatake M, Ikeda K, et al. Abnormal development of fourth aortic arch derivatives in the pathogenesis of tetralogy of Fallot. Pediatr Cardiol. 1990; 11(2): 69–71.
  20. Natsis K, Didagelos M, Gkiouliava A, et al. The aberrant right subclavian artery: cadaveric study and literature review. Surg Radiol Anat. 2017; 39(5): 559–565.
  21. Natsis K, Didagelos M, Manoli SM, et al. A bicarotid trunk in association with an aberrant right subclavian artery. Report of two cases, clinical impact, and review of the literature. Folia Morphol. 2011; 70(2): 68–73.
  22. Ostrowski P, Popovchenko S, Bonczar M, et al. A left circumflex aorta with a displaced thoracic duct in a 94-year-old male cadaver: a case report with discussion on embryology. Folia Morphol. 2022 [Epub ahead of print].
  23. Polguj M, Chrzanowski Ł, Kasprzak JD, et al. The aberrant right subclavian artery (arteria lusoria): the morphological and clinical aspects of one of the most important variations: a systematic study of 141 reports. Sci World J. 2014; 2014: 292734.
  24. Popieluszko P, Henry BM, Sanna B, et al. A systematic review and meta-analysis of variations in branching patterns of the adult aortic arch. J Vasc Surg. 2018; 68(1): 298–306.e10.
  25. Poterucha J, Anavekar N, Niaz T, et al. Incidence and clinical presentation of Kommerell diverticulum and aneurysm. J Am Coll Cardiol. 2015; 65(10): A524.
  26. Puri SK, Ghuman S, Narang P, et al. CT and MR angiography in dysphagia lusoria in adults. Indian J Radiol Imaging. 2005; 15(4): 497.
  27. Sadler TW, Langman J. Langman’s medical embryology. Lippincott Williams & Wilkins, Philadelphia 2004.
  28. Singh S, Grewal PD, Symons J, et al. Adult-onset dysphagia lusoria secondary to a dissecting aberrant right subclavian artery associated with type B acute aortic dissection. Can J Cardiol. 2008; 24(1): 63–65.
  29. Tapia-Nañez M, Landeros-Garcia GA, Sada-Treviño MA, et al. Morphometry of the aortic arch and its branches. A computed tomography angiography-based study. Folia Morphol. 2021; 80(3): 575–582.
  30. Ye Y, Nikolla Z, Hebbar R, et al. A tight spot. Am J Med. 2011; 124(10): 921–923.
  31. Żytkowski A, Tubbs R, Iwanaga J, et al. Anatomical normality and variability: Historical perspective and methodological considerations. Transl Res Anat. 2021; 23: 100105.

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