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Aberrant right subclavian artery

Case contributed by Bruno Di Muzio
Diagnosis certain

Presentation

CTA requested for carotid stenosis evaluation previously spotted on Doppler study.

Patient Data

Age: 80 years
Gender: Female

CTA Neck

ct

The right subclavian artery is the fourth and last aortic arch's branch and hooks back to reach the right side, passing posterior to the esophagus. 

Bovine aortic arch.

Case Discussion

Instead of being the first branch (with the right common carotid as the brachiocephalic artery), aberrant right subclavian artery (ARSA) arises on its own as the fourth branch, after the left subclavian artery. It then hooks back to reach the right side. Aberrant right subclavian arteries relationship to the esophagus is variable:

  • 80 % posterior to esophagus
  • 15 % between esophagus and trachea
  • 5 % anterior to the trachea

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