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CT evaluation of aberrant right subclavian artery: anatomy and clinical implications

Published online by Cambridge University Press:  23 November 2018

Maciej Krupiński ,
Małgorzata Irzyk ,
Zbigniew Moczulski ,
Robert Banyś ,
Ireneusz Dwojak  and
Małgorzata Urbańczyk-Zawadzka
Maciej Krupiński*
Affiliation:
Department of Radiology and Diagnostic Imaging, John Paul II Hospital, Krakow, Poland
Małgorzata Irzyk
Affiliation:
Department of Radiology and Diagnostic Imaging, John Paul II Hospital, Krakow, Poland
Zbigniew Moczulski
Affiliation:
Department of Radiology and Diagnostic Imaging, John Paul II Hospital, Krakow, Poland
Robert Banyś
Affiliation:
Department of Radiology and Diagnostic Imaging, John Paul II Hospital, Krakow, Poland
Ireneusz Dwojak
Affiliation:
Department of Radiology and Diagnostic Imaging, John Paul II Hospital, Krakow, Poland
Małgorzata Urbańczyk-Zawadzka
Affiliation:
Department of Radiology and Diagnostic Imaging, John Paul II Hospital, Krakow, Poland
*
Author for correspondence: Maciej Krupiński, MD, PhD, Department of Radiology and Diagnostic Imaging, John Paul II Hospital, ul. Prądnicka 80, 31-202 Kraków, Poland. Tel/Fax: +48126142526; E-mail: [email protected]
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Abstract

Purpose

The aim of the study was to perform CT angiography-based evaluation of aberrant right subclavian artery prevalence, anatomy, and its influence on clinical symptoms.

Methods

A total of 6833 patients who underwent 64-slice or dual-source CT angiography and those who revealed aberrant right subclavian artery underwent evaluation of its anatomy and were interviewed for the presence of clinical symptoms.

Results

Aberrant right subclavian artery was found in 32 (0.47%) patients consisting of 13 males and 19 females, with mean age of 60.8±13.4 years. Among the interviewed 30 (94%) patients, oesophageal compression was observed in 14 cases (47%) and tracheal compression in three cases (10%). None of the patients underwent surgery related to aberrant right subclavian artery. Dysphagia was the most common clinical symptom in nine cases (30%), and in those patients the median distance between aberrant right subclavian artery and trachea was lower (4 mm) than in individuals without dysphagia (7.5 mm) (p = 0.009). The median lumen area of the aberrant right subclavian artery at the level of oesophagus was higher in patients with dysphagia (208 mm2) compared with individuals without dysphagia (108 mm2) (p = 0.01).

Conclusions

Aberrant right subclavian artery is a rare occurring abnormality in CT angiography. In the evaluated adult population, the most common symptom was dysphagia, which occurred in patients with decreased distance between aberrant right subclavian artery and trachea and increased lumen area of the aberrant artery at the level of compressed oesophagus.

Keywords

Multi-slice CTaberrant right subclavian arteryesophageal dysphagiacardiovascular abnormalitiescross-sectional anatomy
Type
Original Article
Information
Cardiology in the Young , Volume 29 , Issue 2 , February 2019 , pp. 128 - 132
Copyright
© Cambridge University Press 2018 

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Footnotes

Cite this article: Krupiński M, Irzyk M, Moczulski Z, Banyś R, Dwojak I, Urbańczyk-Zawadzka M. (2018) CT evaluation of aberrant right subclavian artery: anatomy and clinical implications. Cardiology in the Young page 128 of 132. doi: 10.1017/S1047951118001907

References

1. 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: 303–315.Google Scholar
2. Freed, K, Low, VH. The aberrant subclavian artery. Am J Roentgenol 1997; 168: 481–484.10.2214/ajr.168.2.9016231Google Scholar
3. Davies, M, Guest, PJ. Developmental abnormalities of the great vessels of the thorax and their embryological basis. Br J Radiol 2003; 76: 491–502.10.1259/bjr/14043447Google Scholar
4. Natsis, KI, Tsitouridis, IA, Didagelos, MV, et al. Anatomical variations in the branches of the human aortic arch in 633 angiographies: clinical significance and literature review. Surg Radiol Anat 2009; 31: 319–323.Google Scholar
5. Levitt, B, Richter, JE. Dysphagia lusoria: a comprehensive review. Dis Esophagus 2007; 20: 455–460.10.1111/j.1442-2050.2007.00787.xGoogle Scholar
6. Van Dyke, CW, White, RD. Congenital abnormalities of the thoracic aorta presenting in the adult. J Thorac Imaging 1994; 9: 230–245.10.1097/00005382-199423000-00004Google Scholar
7. Haesemeyer, SW, Gavant, ML. Imaging of acute traumatic aortic tear in patients with an aberrant right subclavian artery. AJR Am J Roentgenol 1999; 172: 117–120.10.2214/ajr.172.1.9888750Google Scholar
8. 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.Google Scholar
9. Yang, M, Mo, X, Jin, J, et al. Diagnostic value of 64 multislice CT in typing of congenital aortic anomaly in neonates and infants. Zhonghua Yi Xue Za Zhi 2010; 90: 2167–2171.Google Scholar
10. Chen, X, Qu, YJ, Peng, ZY, et al. Diagnosis of congenital aortic arch anomalies in Chinese children by multi-detector computed tomography angiography. J Huazhong Univ Sci Technol: Med Sci 2013; 33: 447–451.Google Scholar
11. Branscom, JJ, Austin, JHM. Aberrant right subclavian artery. Findings seen on plain chest roentgenograms. Am J Roentgenol 1973; 119: 539–542.10.2214/ajr.119.3.539Google Scholar
12. Myers, PO, Fasel, JH, Kalangos, A, et al. Arteria lusoria: developmental anatomy, clinical, radiological and surgical aspects. Ann Cardiol Angeiol (Paris) 2010; 59: 147–154.Google Scholar
13. Bayford, D. An Account of a Singular Case of Obstructed Deglutition. Memoirs of the Medical Society of London, London, 1787.Google Scholar
14. Pelberg, R, Mazur, W. Vascular CT Angiography Manual. Springer-Verlag, London, 2003.Google Scholar
15. Klinkhamer, AC. Aberrant right subclavian artery. Clinical and roentgenologic aspects. Am J Roentgenol 1966; 97: 438–446.Google Scholar
16. Kopp, R, Wizgall, I, Kreuzer, E, et al. Surgical and endovascular treatment of symptomatic aberrant right subclavian artery (arteria lusoria). Vascular 2007; 15: 84–91.Google Scholar
17. Hartyánszky, IL, Lozsadi, K, Marcsek, P, et al. Congenital vascular rings: surgical management of 111 cases. Eur J Cardio-Thorac Surg 1989; 3: 250–254.10.1016/1010-7940(89)90074-2Google Scholar
18. Kommerell, B. Verlagerung des Osophagus durch eine abnormverlaufende Arteria subclavia dextra (Arteria Lusoria). Fortschritte auf dem Gebiete der Röntgenstrahlen 1936; 54: 590–595.Google Scholar
19. Epstein, DA, DeBord, JR. Abnormalities associated with aberrant right subclavian arteries: a case report. Vasc Endovasc Surg 2002; 36: 297–303.10.1177/153857440203600408Google Scholar
20. Kieffer, E, Bahnini, A, Koskas, F. Aberrant subclavian artery: surgical treatment in thirty-three adult patients. J Vasc Surg 1994; 19: 100–111.Google Scholar
21. Barry, A. The aortic arch derivatives in human adult. Anat Rec 1951; 111: 221–238.Google Scholar
22. Bennett, AL, Cock, C, Heddle, R, et al. Dysphagia lusoria: a late onset presentation. World J Gastroenterol 2013: 2433–2436.Google Scholar
23. 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 (Warsz) 2011; 70: 68–73.Google Scholar
24. Donadel, M, Lontra, MB, Cavazzola, LT, et al. Retroesophageal right subclavian artery: a case report and a review of literature. Eur J Anat. 2006; 10: 57–60.Google Scholar