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Incidence and Morphologic Characteristics of Aberrant Subclavian Arteries: A Retrospective Cross-Sectional Study

Year 2025, Volume: 7 Issue: 1, 1 - 7
https://doi.org/10.37990/medr.1532495

Abstract

Aim: The aim of this study to determine the incidence of aberrant right subclavian artery (ARSA) and aberrant left subclavian artery (ALSA), their diameter, angle at their point of origin, distance between them.The cases included in the study were also examined for atrial septal defect (ASD), aneurysm, Kommerell's diverticulum, dysphagia, dyspnea, atherosclerotic heart disease, and hypertension.
Material and Method: This study is a retrospective cross-sectional study conducted at Inonu University Faculty of Medicine Turgut Özal Medical Center. Within the scope of the study, The images of 2365 patients who applied to the Department of Radiology for contrast-enhanced thoracic CT arterial phase imaging were examined. As a result of the review, 52 cases (20 men and 32 women) with ARSA and ALSA were identified and included in the study.
Results: Among the examined images, ARSA was detected in 46 (1.9%) patients, while ALSA was detected in 6 (0.2%) patients. In ARSA cases, ASD and aneurysm were each found in 3 cases. Kommerell's diverticulum was not found in ARSA cases. In ALSA cases, aneurysm was found in 1 case, while Kommerell's diverticulum was found in 5 patients (83.3%). No evidence of ASD was found in ALSA cases. At the origin points, the average diameter of ARSA was 11.7 mm and ALSA was 12.55 mm, with average angles were 76.39° and 60.27°, respectively. The average distance between the right subclavian artery and the left subclavian artery in ARSA cases was 7.27 mm. In ALSA cases, the average distance between the left subclavian artery and the truncus brachiocephalicus was 10.9 mm.
Conclusion: The incidence of ARSA and ALSA in the studied population was 1.9% and 0.2%, respectively. The detailed anatomical characteristics provided in this study can aid in the planning and execution of vascular surgeries involving subclavian arteries.

Ethical Statement

The authors have no conflicts of interest to declare.

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References

  • Hanneman K, Newman B, Chan F. Congenital variants and anomalies of the aortic arch. Radio Graphics. 2017;37:32-51.
  • Freed K, Low VHS. The aberrant subclavian artery. Am J Roentgenol. 1997;168:481-4.
  • Fernando RJ, Altman JM, Çiftçi B, Garner C. Aberrant right subclavian artery: an important variant of the aortic arch. Anesthesiology. 2019;130:615-6.
  • Rasmussen DK, Dougherty J. Aortic dissection with vascular abnormalities. J Am Osteopath Assoc. 2011;111:407-9.
  • Ota T, Okada K, Takanashi S, et al. Surgical treatment for kommerell’s diverticulum. J Thorac Cardiovasc Surg. 2006;131:574-8.
  • Verma M, Pandey NN, Chandrashekhara SH, et al. Anomalous origin of left subclavian artery from ascending aorta in a right aortic arch: a case report with review of literature. J Card Surg. 2021;36:1130-3.
  • Tyczynski P, Michalowska I, Wolny R, et al. Left aberrant subclavian artery. Systematic study in adult patients. Int J Cardiol. 2017;240:183-6.
  • Chowdhury Y, Shaikh SA, Salman A, et al. Aberrant right subclavian artery and stanford type b aortic dissection. Am J Med Case Rep. 2020;8:247-9.
  • Kasahara H, Shin H, Inoue Y. Acute aortic dissection with an aberrant right subclavian artery resulting in rapid false lumen enlargement: a case report. Gen Thorac Cardiovasc Surg Cases. 2023;2:4.
  • Battaloglu B, Secici S, Colak C, et al. Aberrant right subclavian artery and axillary artery cannulation in type a aortic dissection repair. Ann Thorac Surg. 2013;96:e1-2.
  • Özen KE, Çiçekçibaşı AE, Aydoğdu D. Morphologic and morphometric analysis of the subclavian artery and the main branches of the subclavian artery by multidetector computerized tomography (MDCT). Izmir Kâtip Çelebi University Faculty of Health Sciences Journal. 2023;8:101-10.
  • Kiernan PD, Dearani J, Byrne WD, et al. Aneurysm of an aberrant right subclavian artery: case report and review of the literature. Mayo Clin Proc. 1993;68:468-74.
  • Ferrero E, Ferri M, Viazzo A, et al. Aneurysm of the aberrant right subclavian artery: surgical and hybrid repair of two cases in a single center. Ann Vasc Surg. 2011;25:839.e5-839.e8.39E9.
  • Robb CL, Bhalla S, Raptis CA. Subclavian artery: anatomic review and ımaging evaluation of abnormalities. Radiographics. 2022;42:2149-65.
  • Deck M, Grocott HP, Yamashita MY. Aberrant right subclavian artery: an impediment to transesophageal echocardiography. Can J Anaesth. 2021;68:423-4.
  • Büyükkaya A, Büyükkaya R, Özaydın İ, et al. Rarely cause of disphagia: aberrant insertion of the right subclavian artery. Konuralp Medical Journal. 2009;1:22-4.
  • Krupinski M, Irzyk M, Moczulski Z, et al. CT evaluation of aberrant right subclavian artery: anatomy and clinical implications. Cardiol Young. 2019;29:128-32.
  • Cina CS, Althani H, Pasenau J, Abouzahr L. Kommerell’s diverticulum and right-sided aortic arch: a cohort study and review of the literature. J Vasc Surg. 2004;39:131-9.
  • Inam H, Sohail AA, Asif N, Ahmad W. Aberrant right subclavian artery with atrial septal defect: simultaneous repair via median sternotomy. Int J Surg Case Rep. 2020;67:30-3.
  • van Rosendael PJ, Stöger JL, Kiès P, et al. The Clinical spectrum of Kommerell's diverticulum in adults with a right-sided aortic arch: a case series and literature overview. J Cardiovasc Dev Dis. 2021;8:25.
  • Morishita A,Tomioka H, Katahira S, et al. Surgical treatment for Kommerellʼs diverticulum associated with a right-sided aortic arch and an aberrant left subclavian artery: endovascular or hybrid. Ann Vasc Dis. 2019;12:228-32.
  • Lee MW, Kim GH. Kommerell’s diverticulum: a rare cause of esophageal subepithelial lesion. Korean J Intern Med. 2019;34:1392-3.
  • Tsukube T, Ataka K, Sakata M, et al. Surgical treatment of an aneurysm in the right aortic arch with aberrant left subclavian artery. Ann Thorac Surg. 2001;71:1710-1.
  • Ha GJ, Sung MJ, Lee YS, et al. A case of right sided aortic arch combined with atrial septal defect. J Cardiovasc Ultrasound. 201;19:32-4.
  • Alhuzaimi AN, Aldawsari KA, AlAhmadi M. Isolated left subclavian artery with right aortic arch: case report and literature review of 50 cases. Gen Thorac Cardiovasc Surg. 2021;69:885-9.
Year 2025, Volume: 7 Issue: 1, 1 - 7
https://doi.org/10.37990/medr.1532495

Abstract

References

  • Hanneman K, Newman B, Chan F. Congenital variants and anomalies of the aortic arch. Radio Graphics. 2017;37:32-51.
  • Freed K, Low VHS. The aberrant subclavian artery. Am J Roentgenol. 1997;168:481-4.
  • Fernando RJ, Altman JM, Çiftçi B, Garner C. Aberrant right subclavian artery: an important variant of the aortic arch. Anesthesiology. 2019;130:615-6.
  • Rasmussen DK, Dougherty J. Aortic dissection with vascular abnormalities. J Am Osteopath Assoc. 2011;111:407-9.
  • Ota T, Okada K, Takanashi S, et al. Surgical treatment for kommerell’s diverticulum. J Thorac Cardiovasc Surg. 2006;131:574-8.
  • Verma M, Pandey NN, Chandrashekhara SH, et al. Anomalous origin of left subclavian artery from ascending aorta in a right aortic arch: a case report with review of literature. J Card Surg. 2021;36:1130-3.
  • Tyczynski P, Michalowska I, Wolny R, et al. Left aberrant subclavian artery. Systematic study in adult patients. Int J Cardiol. 2017;240:183-6.
  • Chowdhury Y, Shaikh SA, Salman A, et al. Aberrant right subclavian artery and stanford type b aortic dissection. Am J Med Case Rep. 2020;8:247-9.
  • Kasahara H, Shin H, Inoue Y. Acute aortic dissection with an aberrant right subclavian artery resulting in rapid false lumen enlargement: a case report. Gen Thorac Cardiovasc Surg Cases. 2023;2:4.
  • Battaloglu B, Secici S, Colak C, et al. Aberrant right subclavian artery and axillary artery cannulation in type a aortic dissection repair. Ann Thorac Surg. 2013;96:e1-2.
  • Özen KE, Çiçekçibaşı AE, Aydoğdu D. Morphologic and morphometric analysis of the subclavian artery and the main branches of the subclavian artery by multidetector computerized tomography (MDCT). Izmir Kâtip Çelebi University Faculty of Health Sciences Journal. 2023;8:101-10.
  • Kiernan PD, Dearani J, Byrne WD, et al. Aneurysm of an aberrant right subclavian artery: case report and review of the literature. Mayo Clin Proc. 1993;68:468-74.
  • Ferrero E, Ferri M, Viazzo A, et al. Aneurysm of the aberrant right subclavian artery: surgical and hybrid repair of two cases in a single center. Ann Vasc Surg. 2011;25:839.e5-839.e8.39E9.
  • Robb CL, Bhalla S, Raptis CA. Subclavian artery: anatomic review and ımaging evaluation of abnormalities. Radiographics. 2022;42:2149-65.
  • Deck M, Grocott HP, Yamashita MY. Aberrant right subclavian artery: an impediment to transesophageal echocardiography. Can J Anaesth. 2021;68:423-4.
  • Büyükkaya A, Büyükkaya R, Özaydın İ, et al. Rarely cause of disphagia: aberrant insertion of the right subclavian artery. Konuralp Medical Journal. 2009;1:22-4.
  • Krupinski M, Irzyk M, Moczulski Z, et al. CT evaluation of aberrant right subclavian artery: anatomy and clinical implications. Cardiol Young. 2019;29:128-32.
  • Cina CS, Althani H, Pasenau J, Abouzahr L. Kommerell’s diverticulum and right-sided aortic arch: a cohort study and review of the literature. J Vasc Surg. 2004;39:131-9.
  • Inam H, Sohail AA, Asif N, Ahmad W. Aberrant right subclavian artery with atrial septal defect: simultaneous repair via median sternotomy. Int J Surg Case Rep. 2020;67:30-3.
  • van Rosendael PJ, Stöger JL, Kiès P, et al. The Clinical spectrum of Kommerell's diverticulum in adults with a right-sided aortic arch: a case series and literature overview. J Cardiovasc Dev Dis. 2021;8:25.
  • Morishita A,Tomioka H, Katahira S, et al. Surgical treatment for Kommerellʼs diverticulum associated with a right-sided aortic arch and an aberrant left subclavian artery: endovascular or hybrid. Ann Vasc Dis. 2019;12:228-32.
  • Lee MW, Kim GH. Kommerell’s diverticulum: a rare cause of esophageal subepithelial lesion. Korean J Intern Med. 2019;34:1392-3.
  • Tsukube T, Ataka K, Sakata M, et al. Surgical treatment of an aneurysm in the right aortic arch with aberrant left subclavian artery. Ann Thorac Surg. 2001;71:1710-1.
  • Ha GJ, Sung MJ, Lee YS, et al. A case of right sided aortic arch combined with atrial septal defect. J Cardiovasc Ultrasound. 201;19:32-4.
  • Alhuzaimi AN, Aldawsari KA, AlAhmadi M. Isolated left subclavian artery with right aortic arch: case report and literature review of 50 cases. Gen Thorac Cardiovasc Surg. 2021;69:885-9.
There are 25 citations in total.

Details

Primary Language English
Subjects Anatomy
Journal Section Original Articles
Authors

Aydan Dursun 0009-0003-3413-5966

Aymelek Çetin 0000-0002-4645-2059

Serkan Sevgi 0000-0001-6995-0256

İpek Balıkçı Çiçek 0000-0002-3805-9214

Publication Date
Submission Date August 13, 2024
Acceptance Date October 25, 2024
Published in Issue Year 2025 Volume: 7 Issue: 1

Cite

AMA Dursun A, Çetin A, Sevgi S, Balıkçı Çiçek İ. Incidence and Morphologic Characteristics of Aberrant Subclavian Arteries: A Retrospective Cross-Sectional Study. Med Records. 7(1):1-7. doi:10.37990/medr.1532495

17741

Chief Editors

Assoc. Prof. Zülal Öner
Address: İzmir Bakırçay University, Department of Anatomy, İzmir, Türkiye

Assoc. Prof. Deniz Şenol
Address: Düzce University, Department of Anatomy, Düzce, Türkiye

E-mail: medrecsjournal@gmail.com

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