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MORPHOLOGİCAL AND CLİNİCAL ASPECTS OF ABERRANT SUBCLAVİAN ARTERY:SİNGLE CENTER MDCT BASED STUDY

Year 2020, Volume: 8 Issue: 3, 436 - 442, 20.12.2020
https://doi.org/10.37696/nkmj.757833

Abstract

Objectives: Aberrant subclavian artery(ASA) anomalies are the most common aortic arch malformations. Incidence of these malformations increases with widespread use of computed tomography(CT). Our aim in this study was to investigate the relationship between ASA malformations, gender, age and reasons for admission, and Arcus Aorta(AA), ASA diameters and AA/ASA diameter ratios.
Material and Methods: A total 74 patients with ASA were evaluated by Thorax CT retrospectively. Patients were divided into Aberrant right(ARSA) and left(ALSA) subclavian artery groups. Age, gender, reasons for application, ASA and AA diameters and AA/ASA ratios were evaluated between groups. Correlations of ASA and AA diameters with age were also evaluated.
Results: 70(94.5%) of the patients had ARSA, 4(5.4%) of patients had ALSA. There was no statistical relationship between gender(p=0.394), age(p=0.443) and reasons for application(p=0.322) between groups. There was no statistical relationship between ASA diameter(p=0.127), AA diameter(p=0.728) and AA/ASA ratio(p=0.339) between groups. Weak positive correlation with age and diameter of AA(r=0.379,p=0.001) was observed, but no correlation with ASA diameter(p=0.059). Moderate positive correlation(r=0.573,p<0.001) was detected between diameters of AA and ASA.
Conclusion: ASA malformations are the most common incidentally detected malformations with increased use of CT. These malformations are not related to age, gender and reasons for application.

References

  • Referans 1) Polednak AP. Prevalence of the aberrant right subclavian artery reported in a published systematic review of cadaveric studies: The impact of an outlier. Clin Anat. 2017 Nov;30(8):1024-1028. doi: 10.1002/ca.22905. Epub 2017 Jun 15.
  • Referans 2) Muraoka M, Nagata H, Hirata Y, Uike K, Terashi E, Morihana E, et al. High incidence of progressive stenosis in aberrant left subclavian artery with right aortic arch. Heart Vessels. 2018 Mar;33(3):309-315. doi: 10.1007/s00380-017-1056-6. Epub 2017 Sep 30.
  • Referans3) Sabol F, Candik P, Kolesar A, Toporcer T. Rightaortic arch with an aberrant left subclavian artery and aortic coarctationincluding a descendingaortic aneurysm. J Cardiothorac Surg. 2019 Apr 2;14(1):65. doi: 10.1186/s13019-019-0878-y.
  • Referans4) Abraham V, Mathew A, Cherian V, Chandran S, Mathew G. Aberrant subclavian artery: anatomical curiosity or clinical entity. Int J Surg. 2009 Apr;7(2):106-9. doi: 10.1016/j.ijsu.2009.01.009. Epub 2009 Feb 6.
  • Referans 5) Chen X, Qu YJ, Peng ZY, Lu JG, Ma XJ. Diagnosis of congenitalaortic archanomalies in chinesechildren by multi-detector computed tomography angiography. J Huazhong Univ Sci Technolog Med Sci. 2013 Jun;33(3):447-451. doi: 10.1007/s11596-013-1140-9. Epub 2013 Jun 17.
  • Referans 6) Stojanovska J, Cascade PN, Chong S, Quint LE, Sundaram B. Embryology and imagingreview of aortic archanomalies. J Thorac Imaging. 2012 Mar;27(2):73-84. doi: 10.1097/RTI.0b013e318218923c.
  • Referans 7) Karcaaltincaba M, Haliloglu M, Ozkan E, Kocak M, Akinci D, Ariyurek M. Non-invasiveimaging of aberrant right subclavian artery pathologies and aberrant right vertebral artery. Br J Radiol. 2009 Jan;82(973):73-8. doi: 10.1259/bjr/44929969. Epub 2008 Sep 15.
  • Referans 8) Kau T, Sinzig M, Gasser J, Lesnik G, Rabitsch E, Celedin S, et al. Aortic development and anomalies. Semin Intervent Radiol. 2007 Jun;24(2):141-52. doi: 10.1055/s-2007-980040.
  • Referans 9) Choi Y, Chung SB, Kim MS. Prevalence and Anatomy of AberrantRightSubclavian Artery Evaluated by Computed Tomographic Angiography at a Single Institution in Korea. J Korean Neurosurg Soc. 2019 Mar;62(2):175-182. doi: 10.3340/jkns.2018.0048. Epub 2019 Feb 27.
  • Referans 10) Bayford D. An account of a singular case of obstructed deglutition. Memoirs Med Soc London 1794;2:275–286.
  • Referans 11) Hastreiter AR, D’Cruz IA, Cantez T, Namin EP, Licata R. Right-sided aorta. I. Occurrence of right aortic arch in various types of congenital heart disease. II. Right aortic arch, right descending aorta, and associated anomalies. Br Heart J. 1966;28:722–739.
  • Referans 12) Allen SR, Ignacio R, Falcone RA, Alonso MH, Brown RL, Garcia VF, et al. The effect of a right-sided aortic arch on outcome in children with esophageal atresia and tracheoesophageal fistula. J Pediatr Surg. 2006;41:1788–1790.
  • Referans 13) Tyczyński P, Michałowska I, Wolny R, Dobrowolski P, Łazarczyk H, Rybicka J, et al. Left aberrant subclavian artery. Systematic study in adult patients. Int J Cardiol. 2017 Aug 1;240:183-186. doi: 10.1016/j.ijcard.2017.04.052. Epub 2017 Apr 25.
  • Referans 14) Tanaka A, Milner R, Ota T. Kommerell's diverticulum in the current era: a comprehensive review. Gen Thorac Cardiovasc Surg. 2015 May;63(5):245-59. doi: 10.1007/s11748-015-0521-3. Epub 2015 Jan 31.
  • Referans 15) Kommerell B. Verlagerung des o¨sophagus durch eine abnorm verlaufende arteria subclavia dextra (arteria lusoria). Fortschr Geb Roentgenstrahlen. 1936;54:590–5.
  • Referans 16) Mahmodlou R , Sepehrvand N , Hatami S. Aberrant Right Subclavian Artery: A Life-threatening Anomaly That Should Be Considered During Esophagectomy. J Surg Tech Case Rep. 2014 Jul-Dec; 6(2): 61–63. doi: 10.4103/2006-8808.147262.
  • Referans 17) Rosa P, Gillespie DL, Goff JM, O’donnell SD, Starnes B. Aberrant right subclavian artery syndrome: a case of chronic cough. J Vasc Surg 2003;37:1318–21.
  • Referans 18) Krupiński M, Irzyk M, Moczulski Z, Banyś R, Dwojak I, Urbańczyk-Zawadzka M. CTevaluation of aberrantrightsubclavian artery: anatomy and clinical implications. Cardiol Young. 2019 Feb;29(2):128-132. doi: 10.1017/S1047951118001907. Epub 2018 Nov 23.

ABERRAN SUBKLAVİAN ARTERİN MORFOLOJİK VE KLİNİK YÖNLERİ:TEK MERKEZLİ ÇKBT TABANLI ÇALIŞMA

Year 2020, Volume: 8 Issue: 3, 436 - 442, 20.12.2020
https://doi.org/10.37696/nkmj.757833

Abstract

Amaç: Aberran subklavian arter(ASA) anomalileri en sık görülen aortik ark malformasyonlarıdır. Bilgisayarlı tomografi(BT) kullanımının artması ile bu malformasyonların görülme sıklığı artmaktadır. Bizim bu çalışmamızdaki amacımız ASA malformasyonlarının cinsiyet, yaş ve hastaneye başvuru nedenleri arasındaki ilişkiyi araştırmak, Arkus Aorta(AA), ASA çaplarını ve AA/ASA çap oranlarının arasındaki ilişkiyi değerlendirmekti.
Yöntemler: ASA’sı olan 74 hastanın toraks BT’leri retrospektif olarak incelendi. Hastalar , Aberran sağ subklavian arter(ARSA)’sı olan ve Aberran sol subklavian arter(ALSA)’sı olanlar olarak ikiye ayrıldı. İki grup arasında yaş, cinsiyet, başvuru nedenleri , ASA ve AA çapları ve AA/ASA oranları değerlendirildi. Ayrıca ASA, AA çaplarının yaş ile korelasyonu değerlendirildi.
Bulgular: Hastaların 70(%94.5)’inde ARSA, 4(%5.4)’ünde ALSA bulunuyordu. İki grup arasında cinsiyet(p=0.394), yaş(p=0.443) ve başvuru nedenleri(p=0.322) arasında istatistiksel ilişki bulunmuyordu. İki grup arasında ASA çapı(p=0.127), AA çapı(p=0.728) ve AA/ASA oranı(p=0.339) arasında istatistiksel ilişki saptanmadı. Yaş ile AA çapı ile zayıf pozitif korelasyon(r=0.379, p=0.001) izlenirken, ASA çapı ile korelasyon saptanmadı(p=0.059). AA çapı ile ASA çapı arasında orta şiddette pozitif korelasyon(r=0.573, p<0.001) saptandı.
Sonuç: ASA malformasyonları BT kullanımının artmasıyla daha sık görülen, genellikle insidental olarak saptanan malformasyonlardır. Bu malformasyonların yaş, cinsiyet ve başvuru nedenleri ile ilişkisi bulunmamaktadır.

References

  • Referans 1) Polednak AP. Prevalence of the aberrant right subclavian artery reported in a published systematic review of cadaveric studies: The impact of an outlier. Clin Anat. 2017 Nov;30(8):1024-1028. doi: 10.1002/ca.22905. Epub 2017 Jun 15.
  • Referans 2) Muraoka M, Nagata H, Hirata Y, Uike K, Terashi E, Morihana E, et al. High incidence of progressive stenosis in aberrant left subclavian artery with right aortic arch. Heart Vessels. 2018 Mar;33(3):309-315. doi: 10.1007/s00380-017-1056-6. Epub 2017 Sep 30.
  • Referans3) Sabol F, Candik P, Kolesar A, Toporcer T. Rightaortic arch with an aberrant left subclavian artery and aortic coarctationincluding a descendingaortic aneurysm. J Cardiothorac Surg. 2019 Apr 2;14(1):65. doi: 10.1186/s13019-019-0878-y.
  • Referans4) Abraham V, Mathew A, Cherian V, Chandran S, Mathew G. Aberrant subclavian artery: anatomical curiosity or clinical entity. Int J Surg. 2009 Apr;7(2):106-9. doi: 10.1016/j.ijsu.2009.01.009. Epub 2009 Feb 6.
  • Referans 5) Chen X, Qu YJ, Peng ZY, Lu JG, Ma XJ. Diagnosis of congenitalaortic archanomalies in chinesechildren by multi-detector computed tomography angiography. J Huazhong Univ Sci Technolog Med Sci. 2013 Jun;33(3):447-451. doi: 10.1007/s11596-013-1140-9. Epub 2013 Jun 17.
  • Referans 6) Stojanovska J, Cascade PN, Chong S, Quint LE, Sundaram B. Embryology and imagingreview of aortic archanomalies. J Thorac Imaging. 2012 Mar;27(2):73-84. doi: 10.1097/RTI.0b013e318218923c.
  • Referans 7) Karcaaltincaba M, Haliloglu M, Ozkan E, Kocak M, Akinci D, Ariyurek M. Non-invasiveimaging of aberrant right subclavian artery pathologies and aberrant right vertebral artery. Br J Radiol. 2009 Jan;82(973):73-8. doi: 10.1259/bjr/44929969. Epub 2008 Sep 15.
  • Referans 8) Kau T, Sinzig M, Gasser J, Lesnik G, Rabitsch E, Celedin S, et al. Aortic development and anomalies. Semin Intervent Radiol. 2007 Jun;24(2):141-52. doi: 10.1055/s-2007-980040.
  • Referans 9) Choi Y, Chung SB, Kim MS. Prevalence and Anatomy of AberrantRightSubclavian Artery Evaluated by Computed Tomographic Angiography at a Single Institution in Korea. J Korean Neurosurg Soc. 2019 Mar;62(2):175-182. doi: 10.3340/jkns.2018.0048. Epub 2019 Feb 27.
  • Referans 10) Bayford D. An account of a singular case of obstructed deglutition. Memoirs Med Soc London 1794;2:275–286.
  • Referans 11) Hastreiter AR, D’Cruz IA, Cantez T, Namin EP, Licata R. Right-sided aorta. I. Occurrence of right aortic arch in various types of congenital heart disease. II. Right aortic arch, right descending aorta, and associated anomalies. Br Heart J. 1966;28:722–739.
  • Referans 12) Allen SR, Ignacio R, Falcone RA, Alonso MH, Brown RL, Garcia VF, et al. The effect of a right-sided aortic arch on outcome in children with esophageal atresia and tracheoesophageal fistula. J Pediatr Surg. 2006;41:1788–1790.
  • Referans 13) Tyczyński P, Michałowska I, Wolny R, Dobrowolski P, Łazarczyk H, Rybicka J, et al. Left aberrant subclavian artery. Systematic study in adult patients. Int J Cardiol. 2017 Aug 1;240:183-186. doi: 10.1016/j.ijcard.2017.04.052. Epub 2017 Apr 25.
  • Referans 14) Tanaka A, Milner R, Ota T. Kommerell's diverticulum in the current era: a comprehensive review. Gen Thorac Cardiovasc Surg. 2015 May;63(5):245-59. doi: 10.1007/s11748-015-0521-3. Epub 2015 Jan 31.
  • Referans 15) Kommerell B. Verlagerung des o¨sophagus durch eine abnorm verlaufende arteria subclavia dextra (arteria lusoria). Fortschr Geb Roentgenstrahlen. 1936;54:590–5.
  • Referans 16) Mahmodlou R , Sepehrvand N , Hatami S. Aberrant Right Subclavian Artery: A Life-threatening Anomaly That Should Be Considered During Esophagectomy. J Surg Tech Case Rep. 2014 Jul-Dec; 6(2): 61–63. doi: 10.4103/2006-8808.147262.
  • Referans 17) Rosa P, Gillespie DL, Goff JM, O’donnell SD, Starnes B. Aberrant right subclavian artery syndrome: a case of chronic cough. J Vasc Surg 2003;37:1318–21.
  • Referans 18) Krupiński M, Irzyk M, Moczulski Z, Banyś R, Dwojak I, Urbańczyk-Zawadzka M. CTevaluation of aberrantrightsubclavian artery: anatomy and clinical implications. Cardiol Young. 2019 Feb;29(2):128-132. doi: 10.1017/S1047951118001907. Epub 2018 Nov 23.
There are 18 citations in total.

Details

Primary Language English
Subjects Clinical Sciences
Journal Section Orginal Article
Authors

Tuğba İlkem Kurtoğlu Özçağlayan 0000-0003-3849-1194

Ömer Özçağlayan 0000-0001-5036-4919

Gülcan Gücer Şahin 0000-0002-6587-867X

Gülşah Ekici This is me

Hilal Kurtoğlu This is me 0000-0002-6826-5588

Publication Date December 20, 2020
Published in Issue Year 2020 Volume: 8 Issue: 3

Cite

APA Kurtoğlu Özçağlayan, T. İ., Özçağlayan, Ö., Gücer Şahin, G., Ekici, G., et al. (2020). MORPHOLOGİCAL AND CLİNİCAL ASPECTS OF ABERRANT SUBCLAVİAN ARTERY:SİNGLE CENTER MDCT BASED STUDY. Namık Kemal Tıp Dergisi, 8(3), 436-442. https://doi.org/10.37696/nkmj.757833
AMA Kurtoğlu Özçağlayan Tİ, Özçağlayan Ö, Gücer Şahin G, Ekici G, Kurtoğlu H. MORPHOLOGİCAL AND CLİNİCAL ASPECTS OF ABERRANT SUBCLAVİAN ARTERY:SİNGLE CENTER MDCT BASED STUDY. NKMJ. December 2020;8(3):436-442. doi:10.37696/nkmj.757833
Chicago Kurtoğlu Özçağlayan, Tuğba İlkem, Ömer Özçağlayan, Gülcan Gücer Şahin, Gülşah Ekici, and Hilal Kurtoğlu. “MORPHOLOGİCAL AND CLİNİCAL ASPECTS OF ABERRANT SUBCLAVİAN ARTERY:SİNGLE CENTER MDCT BASED STUDY”. Namık Kemal Tıp Dergisi 8, no. 3 (December 2020): 436-42. https://doi.org/10.37696/nkmj.757833.
EndNote Kurtoğlu Özçağlayan Tİ, Özçağlayan Ö, Gücer Şahin G, Ekici G, Kurtoğlu H (December 1, 2020) MORPHOLOGİCAL AND CLİNİCAL ASPECTS OF ABERRANT SUBCLAVİAN ARTERY:SİNGLE CENTER MDCT BASED STUDY. Namık Kemal Tıp Dergisi 8 3 436–442.
IEEE T. İ. Kurtoğlu Özçağlayan, Ö. Özçağlayan, G. Gücer Şahin, G. Ekici, and H. Kurtoğlu, “MORPHOLOGİCAL AND CLİNİCAL ASPECTS OF ABERRANT SUBCLAVİAN ARTERY:SİNGLE CENTER MDCT BASED STUDY”, NKMJ, vol. 8, no. 3, pp. 436–442, 2020, doi: 10.37696/nkmj.757833.
ISNAD Kurtoğlu Özçağlayan, Tuğba İlkem et al. “MORPHOLOGİCAL AND CLİNİCAL ASPECTS OF ABERRANT SUBCLAVİAN ARTERY:SİNGLE CENTER MDCT BASED STUDY”. Namık Kemal Tıp Dergisi 8/3 (December 2020), 436-442. https://doi.org/10.37696/nkmj.757833.
JAMA Kurtoğlu Özçağlayan Tİ, Özçağlayan Ö, Gücer Şahin G, Ekici G, Kurtoğlu H. MORPHOLOGİCAL AND CLİNİCAL ASPECTS OF ABERRANT SUBCLAVİAN ARTERY:SİNGLE CENTER MDCT BASED STUDY. NKMJ. 2020;8:436–442.
MLA Kurtoğlu Özçağlayan, Tuğba İlkem et al. “MORPHOLOGİCAL AND CLİNİCAL ASPECTS OF ABERRANT SUBCLAVİAN ARTERY:SİNGLE CENTER MDCT BASED STUDY”. Namık Kemal Tıp Dergisi, vol. 8, no. 3, 2020, pp. 436-42, doi:10.37696/nkmj.757833.
Vancouver Kurtoğlu Özçağlayan Tİ, Özçağlayan Ö, Gücer Şahin G, Ekici G, Kurtoğlu H. MORPHOLOGİCAL AND CLİNİCAL ASPECTS OF ABERRANT SUBCLAVİAN ARTERY:SİNGLE CENTER MDCT BASED STUDY. NKMJ. 2020;8(3):436-42.