A systematic classification of the left-sided aortic arch variants based on cadaveric studies' prevalence

Retroesophageal right subclavian artery associated with a bicarotid trunk and an ectopic origin of vertebral arteries

“…The outcomes of this rare embryological scenario led to the described exceptional case, in which vascular variations of the main branches of the AA and an ectopic origin of both the VAs coexist. This was previously observed only in very few works [8,9,11,14,15], which testify the rareness of this work in the extensive panorama of the anatomical variations of this area.…”

“…Retroesophageal ARSA is one of the most common anomalies in the AA, as it has been recently reported by Natsis et al who reported a prevalence of 8% [ 11 ]. From an embryological point of view, the proximal part of RSA derives from the right fourth arch, while the distal part derives from the right dorsal aorta and the right seventh intersegmental artery; differently, LSA derived entirely from the left seventh intersegmental artery.…”

“…However, an ectopic origin of bilateral VA coexisting with ARSA and a bicarotid trunk (biCT), represents a very rare anatomical variant that was described In memory: Luigi Fabrizio Rodella. mainly radiologically, during magnetic resonance angiography, or by schematic diagram [3,5,8,11,13,15].…”

“…Variations in the origin of the VAs are reported in the literature [ 8 ]. The most common VA variant is the left VA (LVA) arising directly from the AA (0.79–8%) [ 8 , 11 ], whereas for the right VA (RVA) from the RCCA was reported with a low incidence (0.18%) [ 3 ].…”

“…Gluncic et al [ 3 ] reported an unusual origin of both VAs directly from the common trunk of VA and SA, on the left, and RCCA on the right. However, an ectopic origin of bilateral VA coexisting with ARSA and a bicarotid trunk (biCT), represents a very rare anatomical variant that was described mainly radiologically, during magnetic resonance angiography, or by schematic diagram [ 3 , 5 , 8 , 11 , 13 , 15 ].…”