Ruptured aneurysm of an aberrant right subclavian artery: CT and angiographic findings

Schnarkowski, P; Weidenmaier, W; Gumppenberg, R. von

doi:10.1016/0720-048x(92)90140-5

Cited by 4 publications

(2 citation statements)

References 3 publications

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“…Once the NRILN is found during surgery, a subsequent investigation to rule out a vascular abnormality Á especially an aneurysm Á is necessary, because an aneurysm associated with an aberrant subclavian artery is likely to rupture and the mortality associated with a rupture is 100% [5,19,20]. Our case supports the significance of the postoperative investigation, as MRA administered after finding the NRILN revealed aplasia of the bilateral posterior communicating arteries in addition to the expected aberrant right subclavian artery, although no aneurysm was found.…”

Section: Discussionmentioning

confidence: 99%

Non-recurrent inferior laryngeal nerve with multiple arterial abnormalities

Kobayashi

Abe

Okamoto

et al. 2007

Acta Oto-Laryngologica

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Non-recurrent inferior laryngeal nerve (NRILN) is a rare embryologic anomaly that can increase the risk of injury during thyroid surgery. Although the association between the NRILN and an aberrant right subclavian artery has been reported, to date there have been no reports describing cases of NRILN with multiple vascular abnormalities. A 60-year-old man with papillary thyroid carcinoma and a history of right internal carotid artery occlusion by thrombosis was examined with magnetic resonance angiography (MRA). The right NRILN was found during a total thyroidectomy with surrounding lymph node dissection. MRA revealed an aberrant right subclavian artery and aplasia of the bilateral posterior communicating arteries composing the circle of Willis. This is the first clinical report demonstrating NRILN with multiple vascular abnormalities. Patients with NRILN must be examined for vascular anomalies and associated lesions such as aneurysms and thromboembolism.

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Section: Discussionmentioning

confidence: 99%

Non-recurrent inferior laryngeal nerve with multiple arterial abnormalities

Kobayashi

Abe

Okamoto

et al. 2007

Acta Oto-Laryngologica

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“…David Bayford, an English surgeon, coined the term dysphagia lusoria or dysphagia as a "freak of nature" in 1787.15 He described his account of a patient, Jane Fordham, who died from starvation. She first became symptomatic at age 12 and was unable swallow solid food for the last few years of her life. She died at the age of 60.16 Although Bayford's case is the first to note the link between the ARSA and dysphagia lusoria, Hunauld is credited for first describing the anatomic anomaly in 1735.…”

Section: Discussionmentioning

confidence: 99%

Abnormalities Associated with Aberrant Right Subclavian Arteries

Epstein

DeBord

2002

Vasc Endovascular Surg

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An aberrant right subclavian artery (ARSA) is an anomaly with a reported incidence of 0.5% to 2%. Usually the aberrant artery follows a retroesophageal course; rarely it takes a course anterior to the esophagus or the trachea. Most patients with an ARSA remain asymptomatic; however, progressive dysphagia develops occasionally. The choice of approach depends on the presence or absence of aneurysmal disease, the urgency of the operation, and the surgeon's experience. A case is reported of a 33-year-old white male patient who had a 3-year history of progressive dysphagia to the point that he was only able to swallow liquids. A barium swallow demonstrated a posterior extrinsic compression of the esophagus. Angiography was performed, which demonstrated an ARSA with a common origin of the right and left common carotid arteries. Surgical correction was performed via a right supraclavicular neck incision. The proximal aberrant artery was mobilized behind the esophagus. The distal, right subclavian artery was exposed, transected, and transposed with reimplantation into the right common carotid artery. An aberrant right thoracic duct was encountered and ligated. The English language literature from 1960 to present was reviewed via a Medline search. Reported anomalies associated with ARSAs include a nonrecurrent right inferior laryngeal nerve, a common origin of the common carotid arteries, a replaced right or left vertebral artery, coarctation of the aorta, a right-sided thoracic duct, and a right-sided aortic arch. It is important to be aware of these associated anomalies and how they impact the operative approach involved in the correction of dysphagia lusoria.

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