Aberrant subclavian artery: Anatomical curiosity or clinical entity

Abstract

Dysphagia lusoria, caused by aberrant subclavian artery, is an uncommon cause of dysphagia. When present it is mostly asymptomatic. Barium esophagogram may indicate the presence of this anomaly. Diagnosis needs to be confirmed by CT/MRI prior to any intervention. No treatment is required for asymptomatic patients. If causing significant symptoms, operative management offers definitive treatment. The choice of treatment depends on local expertise, equipment and experience of the surgical team. However, for those who are unfit or refuse operative intervention, there is a role for symptomatic and supportive treatment. Our cases demonstrate three different manifestations of this single entity.

Congenital anomalies of the aortic arch

“…This anomaly results from involution of right arch between the right subclavian and the right common carotid artery along with regression of the right ductus arteriosus. The proximal segment of the ARSA arises from the distal right dorsal aorta instead of arising from the right fourth arch and follows a retroesophageal course (32). This anomaly does not result in complete vascular ring as there is nothing on the right side of trachea.…”

Hallazgo de arteria lusoria en el estudio de otitis media a repetición: A propósito de una observación pediátrica y revista breve de la literatura

“…La AL es retroesofágica en 80%-83% de los casos, puede tener un trayecto inter-tráqueo-esofágico en 12%-15% o pretraqueal solo en 4% [10][11][12] . Se encuentra más frecuentemente en niños con síndrome de Down (primera citación en 1950), síndrome de Edwards y trisomía 13 sino también en pacientes triploides, monocómicos X con depleción 22 13,14 .…”

Aberrant right subclavian artery: A life-threatening anomaly that should be considered during esophagectomy

“…Noninvasive angiography methods (either CT or the magnetic resonance imaging) can be great confirmatory modality. [ 1 2 4 6 13 ] Multislice CT can diagnose this anomaly with high accuracy and also Esophagectomy may reveal a pulsatile impression in the posterior wall of the esophagus. [ 14 ]…”

“…The anomaly may be associated with some clinical manifestations such as dyspnea, stridor, dysphagia (which is called dysphagia lusoria), chest pain or fever,[ 4 5 6 ] but majority of cases with ARSA are asymptomatic.…”