Right retroesophageal subclavian artery

Abstract

PURPOSE: The subclavian arteries can vary on their origin, course or length. One of the most common anatomical variations is the right subclavian artery originating as the last branch of the aortic arch. This artery is known as a retroesophageal right subclavian artery or "lusory artery". The right retroesophageal subclavian artery usually is described as not producing symptoms, being most discoveries coincidental. Nevertheless, it may be the site of formation of atherosclerotic plaque, inflammatory lesions or aneurysm. CASE REPORT: The present study describes a case of right retroesophageal subclavian artery and discusses the findings according to their clinical and surgical implications. CONCLUSION: The anatomic and morphologic variations of the aortic arch and its branches are significant for diagnostic and surgical procedures in the thorax and neck. If a right retroesophageal subclavian artery is diagnosed during aortic arch repair, corrective surgery should be considered. Intensive care patients should be screened before long term placement of nasogastic tube, in order to avoid fistulization and fatal hemorrhage.<br>OBJETIVO: A artéria subclávia pode ser variável em sua origem, trajeto e/ou comprimento. Uma das variações anatômicas mais comuns é a origem da artéria subclávia direita como o último ramo do arco aórtico. Essa artéria é conhecida como artéria subclávia retroesofágica ou "artéria lusória". A artéria subclávia direita retroesofágica é comumente descrita como assintomática, sendo os achados, na maioria das vezes, acidentais. Entretanto, essa artéria pode ser um sítio de formação de placas ateromatosas, lesões inflamatórias ou até aneurismas. RELATO DE CASO: O presente estudo descreve um caso de artéria subclávia direita retroesofágica e discute os achados de acordo com sua importância clínica e implicações cirúrgicas. CONCLUSÃO: Variações anatômicas do arco aórtico e seus ramos são significantes para diagnósticos e procedimentos cirúrgicos do pescoço e do tórax. Caso uma artéria subclávia direita retroesofágica seja diagnosticada durante uma cirurgia do arco aórtico, um procedimento corretivo deve ser considerado. Pacientes em terapia intensiva devem ser investigados para a presença dessa variação anatômica antes de uma sondagem nasogástica de longa duração para se evitar complicações como fístulas e hemorragia

Anatomy and radiology of the variations of aortic arch branches in 1,266 patients

“…They are, however, more important for thoracic operations, especially in vascular, cardiac, oesophageal, and mediastinal surgery [1,9,12,14,34]. Modern radiological techniques, especially computerised tomographic angiography (CTA), magnetic resonance angiography (MRA), multislice CT (MSCT), and MSCT angiography, have enabled an elegant insight into the thoracic blood vessels [21,27].…”

Anatomical organization of aortic arch variations in the India: embryological basis and review

“…Intensive care patients should be screened before long term placement of nasogastric tube, in order to avoid fistulization and fatal hemorrhage. 14 Momma et al described that aortic arch anomalies are also associated with chromosome 22q11 deletion. 15 The present study describes the aortic arch branching pattern in Indian subjects and discusses the findings according to their embryological, clinical and surgical implications.…”

Anatomical Variations in the Origin of Brachiocephalic Trunk and Left Common Carotid Artery From the Arch of Aorta: A Cadaveric Study

“…Correct identification of these vessels is very important for appropriate invasive techniques in order to achieve desired objectives and to avoid major complications especially during vascular surgery. The anatomical variations in the origin of brachiocephalic trunk and left common carotid artery from the arch of aorta are significant for diagnostic and surgical procedures in the thorax and neck [6,7].…”