Anatomic Investigation of Two Cases of Aberrant Right Subclavian Artery Syndrome, Including the Effects on External Vascular Dimensions

Mirande, Mitchell H.; Durhman, Madelyn R.; Smith, Heather F.

doi:10.3390/diagnostics10080592

Cited by 4 publications

(4 citation statements)

References 25 publications

(144 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In patients without trauma, frequent etiologies of aortic arch and side-branch dissection are variants in the branching pattern of the aortic arch, predisposing the patient to intimal tearing. Aortic arch dissection is more frequent in patients presenting with a bovine arch, CoA, Kommorell aneurysm, a bicarotid trunk, or arteria lusoria with aneurysm formation [ 71 , 72 ]. CTA and MRA results showed that, in about 10–25% of the examined individuals, the aortic arch’s branches did not follow the “normal/usual” branching pattern, with variations in their numbers and origins [ 22 , 73 ].…”

Section: Discussionmentioning

confidence: 99%

Clinical Characteristics and Outcomes of Aortic Arch Emergencies: Takayasu Disease, Fibromuscular Dysplasia, and Aortic Arch Pathologies: A Retrospective Study and Review of the Literature

et al. 2023

View full text Add to dashboard Cite

Non-atherosclerotic aortic arch pathologies (NA-AAPs) and anatomical variants are characterized as rare cardiovascular diseases with a low incidence rate, below 1 case per 2000 population, but enormous heterogeneity in terms of anatomical variants, i.e., Takayasu disease (TAK) and fibromuscular dysplasia (FMD). In specific clinical scenarios, NA-AAPs constitute life-threatening disorders. Methods: In this study, 82 (1.07%) consecutive patients with NA-AAPs (including 38 TAKs, 26 FMDs, and 18 other AAPs) out of 7645 patients who underwent endovascular treatment (EVT) for the aortic arch and its side-branch diseases at a single institution between 2002 and 2022 were retrospectively reviewed. The recorded demographic, biochemical, diagnostic, operative, and postoperative factors were reviewed, and the functional outcomes were determined during follow-up. A systematic review of the literature was also performed. Results: The study group comprised 65 (79.3%) female and 17 (21.7%) male subjects with a mean age of 46.1 ± 14.9 years. Overall, 62 (75.6%) patients were diagnosed with either cerebral ischemia symptoms or aortic arch dissection on admission. The EVT was feasible in 59 (72%) patients, whereas 23 (28%) patients were referred for medical treatment. In EVT patients, severe periprocedural complications occurred in two (3.39%) patients, including one periprocedural death and one cerebral hyperperfusion syndrome. During a median follow-up period of 64 months, cardiovascular events occurred in 24 (29.6%) patients (5 deaths, 13 ISs, and 6 myocardial infarctions). Repeated EVT for the index lesion was performed in 21/59 (35.6%) patients, including 19/33 (57.6%) in TAK and 2/13 (15.4%) in FMD. In the AAP group, one patient required additional stent-graft implantation for progressing dissection to the iliac arteries at 12 months. A baseline white blood count (odds ratio [HR]: 1.25, 95% confidence interval [CI]: 1.11–1.39; p < 0.001) was the only independent prognostic factor for recurrent stenosis, while a baseline hemoglobin level (HR: 0.73, 95%CI: 0.59–0.89; p = 0.002) and coronary involvement (HR: 4.11, 95%CI: 1.74–9.71; p = 0.001) were independently associated with a risk of major cardiac and cerebral events according to the multivariate Cox proportional hazards regression analysis. Conclusions: This study showed that AAPs should not be neglected in clinical settings, as it can be a life-threatening condition requiring a multidisciplinary approach. The knowledge of prognostic risk factors for adverse outcomes may improve surveillance in this group of patients.

show abstract

Section: Discussionmentioning

confidence: 99%

Clinical Characteristics and Outcomes of Aortic Arch Emergencies: Takayasu Disease, Fibromuscular Dysplasia, and Aortic Arch Pathologies: A Retrospective Study and Review of the Literature

et al. 2023

View full text Add to dashboard Cite

show abstract

“…El esofagograma demostró una impresión posterior del esófago y la angiotomografía computada de tórax evidenció la arteria subclavia derecha aberrante siguiendo un trayecto retroesofágico. 9,12 Como se ha descrito, usualmente cursa asintomática, sin embargo, los pacientes con síntomas requieren tratamiento quirúrgico. 10 En nuestro caso se realizó toracotomía izquierda más división y sutura de arteria subclavia derecha aberrante.…”

Section: Discussionunclassified

“…La angiotomografía computada, usualmente, confirma el diagnóstico. 8,9 Los pacientes sintomáticos requieren intervención quirúrgica. 10…”

Section: Introductionunclassified

Arteria subclavia derecha aberrante: a propósito de un caso pediátrico

et al. 2021

View full text Add to dashboard Cite

Los anillos vasculares son anomalías anatómicas que ocurren durante el desarrollo embrionario del arco aórtico, sus ramas y de la arteria pulmonar. Estas estructuras vasculares pueden conducir a grados variables de sintomatología respiratoria y/o digestiva debido a la formación de un anillo completo o parcial que comprime la tráquea y/o el esófago. La arteria subclavia derecha aberrante es la anomalía más común del arco aórtico, con una incidencia reportada entre 0.5 a 2.5%. Generalmente es asintomática, sin embargo, la disfagia es el síntoma más frecuente porque en la mayoría de los casos transcurre detrás del esófago. El diagnóstico puede ser incidental en casos asintomáticos o como resultado del estudio de síntomas digestivos y/o respiratorios persistentes o recurrentes. Los pacientes sintomáticos requieren intervención quirúrgica. Describimos el caso de una paciente de 3 meses de edad con arteria subclavia derecha aberrante. El esofagograma mostró compresión extrínseca del esófago, y la angiotomografía computada confirmó el diagnóstico. La corrección quirúrgica se realizó exitosamente.

show abstract

“…A previously undescribed relationship was revealed in which the tibia grows relatively faster than the fibula, resulting in valgus angulation. Mirande and colleagues described two cases of retroesophageal aberrant right subclavian artery (ARSA) and demonstrated the enlarged size of the vessel relative to a normal sample [ 10 ]. As patients with this condition may present with dysphagia or be asymptomatic, they suggest that the relative size of the ARSA may dictate the severity of the associated symptomatology.…”

mentioning

confidence: 99%