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Aberrant Right Subclavian Artery in Prenatal Diagnosis: A Retrospective Study

Year 2025, Volume: 7 Issue: 2, 412 - 418, 09.05.2025
https://doi.org/10.37990/medr.1641836

Abstract

Aim: Aberrant right subclavian artery (ARSA) is the most common anomaly of the aortic arch and occurs in 1-2% of the population. Although it is usually asymptomatic, its prenatal detection has gained importance due to associations with chromosomal abnormalities, including trisomy 21 and 22q11.2 microdeletion. This study examines isolated (iARSA) and non-isolated ARSA (niARSA), focusing on diagnostic approaches and neonatal outcomes.
Material and Method: In this retrospective study, 29 pregnancies diagnosed with ARSA between October 2022 and January 2024 were analyzed. Fetuses were classified as iARSA or niARSA based on additional structural or chromosomal findings. Data were collected from high-resolution ultrasound examinations and medical records, and statistical comparisons were performed using SPSS v25.0.
Results: There were a total of 29 cases of ARSA, of which 16 were iARSA (55.2%) and 13 were niARSA (44.8%). Non-invasive prenatal testing was performed in 68.7% of iARSA cases, all of which had normal results. In contrast, invasive testing was performed in 38.5% of niARSA cases, with chromosomal abnormalities detected in two cases (trisomy 21). Neonatal outcomes were favorable in iARSA, with 15 cases discharged without complications. NiARSA cases had higher morbidity, including NICU admissions (46%) and congenital heart defects, which in some cases required surgical intervention.
Conclusion: ARSA is an important marker in prenatal diagnosis. While iARSA generally indicates favorable outcomes, niARSA correlates strongly with unfavorable neonatal outcomes and chromosomal abnormalities. The distinction between iARSA and niARSA is crucial for tailored prenatal management and optimization of neonatal care strategies.

Ethical Statement

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee at which the studies were conducted (Clinical Research Ethics Committee of Ankara Etlik City Hospital No. 1 (Decision No.: AEŞH-EK-2024-001, date: 31/01/2024) and with the 2013 Helsinki declaration and its later amendments or comparable ethical standards.

References

  • Annetta R, Nisbet D, O'Mahony E, Palma-Dias R. Aberrant right subclavian artery: embryology, prenatal diagnosis and clinical significance. Ultrasound. 2022;30:284-91.
  • Luo T, Liu S, Ran S, et al. Associated congenital anomalies and genetic anomalies in fetuses with isolated and non-isolated aberrant right subclavian artery. J Matern Fetal Neonatal Med. 2023;36:2211705.
  • Saraç T, Erzincan SG, Uygur L, et al. Isolated aberrant right subclavian artery: should invasive intervention be recommended in the era of noninvasive prenatal tests?. J Ist Faculty Med. 2023;86:37-43.
  • Morlando M, Morelli C, Del Gaizo F, et al. Aberrant right subclavian artery: the association with chromosomal defects and the related post-natal outcomes in a third level referral centre. J Obstet Gynaecol. 2022;42:239-43.
  • Aygün EG, Sarı U, Pata Ö, Dilek TUK. Isolated aberran subclavian artery diagnosed in the second trimester examination: how should we approach? Dicle Med J. 2022;49:119-24.
  • Scala C, Leone Roberti Maggiore U, Candiani M, et al. Aberrant right subclavian artery in fetuses with Down syndrome: a systematic review and meta-analysis. Ultrasound Obstet Gynecol. 2015;46:266-76.
  • Borenstein M, Minekawa R, Zidere V, et al. Aberrant right subclavian artery at 16 to 23 + 6 weeks of gestation: a marker for chromosomal abnormality. Ultrasound Obstet Gynecol. 2010;36:548-52.
  • De León-Luis J, Gámez F, Bravo C, et al. Second-trimester fetal aberrant right subclavian artery: original study, systematic review and meta-analysis of performance in detection of Down syndrome. Ultrasound Obstet Gynecol. 2014;44:147-53.
  • Nedelcu AH, Lupu A, Moraru MC, et al. Morphological aspects of the aberrant right subclavian artery-a systematic review of the literature. J Pers Med. 2024;14:335.
  • Özkan S, Aksan A, Fıratlıgil FB, et al. Persistent right umbilical vein: clinical outcomes and prognostic factors in prenatal diagnosis. South Clin Istanb Eurasia. 2024;35:359-63.
  • Ranzini AC, Hyman F, Jamaer E, van Mieghem T. Aberrant right subclavian artery: correlation between fetal and neonatal abnormalities and abnormal genetic screening or testing. J Ultrasound Med. 2017;36:785-90.

Year 2025, Volume: 7 Issue: 2, 412 - 418, 09.05.2025
https://doi.org/10.37990/medr.1641836

Abstract

References

  • Annetta R, Nisbet D, O'Mahony E, Palma-Dias R. Aberrant right subclavian artery: embryology, prenatal diagnosis and clinical significance. Ultrasound. 2022;30:284-91.
  • Luo T, Liu S, Ran S, et al. Associated congenital anomalies and genetic anomalies in fetuses with isolated and non-isolated aberrant right subclavian artery. J Matern Fetal Neonatal Med. 2023;36:2211705.
  • Saraç T, Erzincan SG, Uygur L, et al. Isolated aberrant right subclavian artery: should invasive intervention be recommended in the era of noninvasive prenatal tests?. J Ist Faculty Med. 2023;86:37-43.
  • Morlando M, Morelli C, Del Gaizo F, et al. Aberrant right subclavian artery: the association with chromosomal defects and the related post-natal outcomes in a third level referral centre. J Obstet Gynaecol. 2022;42:239-43.
  • Aygün EG, Sarı U, Pata Ö, Dilek TUK. Isolated aberran subclavian artery diagnosed in the second trimester examination: how should we approach? Dicle Med J. 2022;49:119-24.
  • Scala C, Leone Roberti Maggiore U, Candiani M, et al. Aberrant right subclavian artery in fetuses with Down syndrome: a systematic review and meta-analysis. Ultrasound Obstet Gynecol. 2015;46:266-76.
  • Borenstein M, Minekawa R, Zidere V, et al. Aberrant right subclavian artery at 16 to 23 + 6 weeks of gestation: a marker for chromosomal abnormality. Ultrasound Obstet Gynecol. 2010;36:548-52.
  • De León-Luis J, Gámez F, Bravo C, et al. Second-trimester fetal aberrant right subclavian artery: original study, systematic review and meta-analysis of performance in detection of Down syndrome. Ultrasound Obstet Gynecol. 2014;44:147-53.
  • Nedelcu AH, Lupu A, Moraru MC, et al. Morphological aspects of the aberrant right subclavian artery-a systematic review of the literature. J Pers Med. 2024;14:335.
  • Özkan S, Aksan A, Fıratlıgil FB, et al. Persistent right umbilical vein: clinical outcomes and prognostic factors in prenatal diagnosis. South Clin Istanb Eurasia. 2024;35:359-63.
  • Ranzini AC, Hyman F, Jamaer E, van Mieghem T. Aberrant right subclavian artery: correlation between fetal and neonatal abnormalities and abnormal genetic screening or testing. J Ultrasound Med. 2017;36:785-90.
There are 11 citations in total.

Details

Primary Language English
Subjects Obstetrics and Gynaecology
Journal Section Original Articles
Authors

Sadullah Özkan 0000-0003-2432-1434

Mustafa Alperen Aksan 0000-0001-7623-3589

Publication Date May 9, 2025
Submission Date February 18, 2025
Acceptance Date March 5, 2025
Published in Issue Year 2025 Volume: 7 Issue: 2

Cite

AMA Özkan S, Aksan MA. Aberrant Right Subclavian Artery in Prenatal Diagnosis: A Retrospective Study. Med Records. May 2025;7(2):412-418. doi:10.37990/medr.1641836

Chief Editors
Prof. Dr. Berkant Özpolat, MD
Department of Thoracic Surgery, Ufuk University, Dr. Rıdvan Ege Hospital, Ankara, Türkiye

Editors
Prof. Dr. Sercan Okutucu, MD
Department of Cardiology, Ankara Lokman Hekim University, Ankara, Türkiye

Assoc. Prof. Dr. Süleyman Cebeci, MD
Department of Ear, Nose and Throat Diseases, Gazi University Faculty of Medicine, Ankara, Türkiye

Field Editors
Assoc. Prof. Dr. Doğan Öztürk, MD
Department of General Surgery, Manisa Özel Sarıkız Hospital, Manisa, Türkiye

Assoc. Prof. Dr. Birsen Doğanay, MD
Department of Cardiology, Ankara Bilkent City Hospital, Ankara, Türkiye

Assoc. Prof. Dr. Sonay Aydın, MD
Department of Radiology, Erzincan Binali Yıldırım University Faculty of Medicine, Erzincan, Türkiye

Language Editors
PhD, Dr. Evin Mise
Department of Work Psychology, Ankara University, Ayaş Vocational School, Ankara, Türkiye

Dt. Çise Nazım
Department of Periodontology, Dr. Burhan Nalbantoğlu State Hospital, Lefkoşa, North Cyprus

Statistics Editor
Dr. Nurbanu Bursa, PhD
Department of Statistics, Hacettepe University, Faculty of Science, Ankara, Türkiye

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