aberrant right subclavian artery

Arteria
lusoria in der Schluckuntersuchung. Bei unklaren Schluckbeschwerden als Zufallsbefund aufgefallen. Auch eine große Struma war nicht als Ursache auszumachen.
Wikipedia • CC BY-SA 3.0
A. lusoria
mit erheblichen Verkalkungen des Aortenbogens und der A. lusoria selbst. Zusätzlich noch Lobus V. azygos mit feiner Fissur.
Wikipedia • CC BY-SA 4.0
Impression
der Speiseröhre durch die von links unten nach rechts ziehende Arteria lusoria in der Breischluckuntersuchung. Links im Bild Ansicht von vorne, rechts seitlich.
Wikipedia • CC BY-SA 3.0
Arteria
lusoria in der Schluckuntersuchung: Impression der Speiseröhre von hinten.
Wikipedia • CC BY-SA 3.0
An additional
challenge for head and neck radiologists: anatomic variants posing a surgical risk – a pictorial review. Aberrant right subclavian artery. Axial (a) and coronal (b) MIP thin reconstruction of a CT angiography of chest showing aberrant retroesophageal course of the right subclavian artery (arrowheads)
insightsimaging.springeropen.com • CC-by-4.0
Aberrant
right subclavian artery • Aberrant right subclavian artery - Ganzer Fall bei Radiopaedia
Galbat E, Aberrant right subclavian artery. Case study, Radiopaedia.org (Accessed on 29 Mar 2023) https://doi.org/10.53347/rID-46271 • CC by-nc-sa 3.0 (modified)
Aberrant
right subclavian artery • Aberrant right subcvlavian artery - MR angiography - Ganzer Fall bei Radiopaedia
Schubert R, Aberrant right subcvlavian artery - MR angiography. Case study, Radiopaedia.org (Accessed on 29 Mar 2023) https://doi.org/10.53347/rID-13708 • CC by-nc-sa 3.0 (modified)
Aberrant
right subclavian artery • Aberrant right subclavian artery with background Takayasu arteritis - Ganzer Fall bei Radiopaedia
Kumar A, Aberrant right subclavian artery with background Takayasu arteritis. Case study, Radiopaedia.org (Accessed on 29 Mar 2023) https://doi.org/10.53347/rID-21423 • CC by-nc-sa 3.0 (modified)
Aberrant
right subclavian artery • Aberrant right subclavian artery aneurysm - Ganzer Fall bei Radiopaedia
Slater L, Aberrant right subclavian artery aneurysm. Case study, Radiopaedia.org (Accessed on 29 Mar 2023) https://doi.org/10.53347/rID-13747 • CC by-nc-sa 3.0 (modified)
Aberrant
right subclavian artery • Dysphagia lusoria - aberrant right subclavian artery - Ganzer Fall bei Radiopaedia
Ho A, Dysphagia lusoria - aberrant right subclavian artery. Case study, Radiopaedia.org (Accessed on 29 Mar 2023) https://doi.org/10.53347/rID-28543 • CC by-nc-sa 3.0 (modified)
Preschooler
with heartburn after eating. Lateral image from an UGI exam (above left) shows a persistent posterior indentation on the proximal esophagus. Sagittal CT with contrast of the chest (above right) shows an aberrant artery located posterior to the esophagus and anterior to a vertebral body. Axial CT (below) shows the right subclavian artery to be arising aberrantly from the aorta and coursing anterior to the vertebral body and posterior to the aerated trachea and collapsed esophagus.The diagnosis was left aortic arch with aberrant right subclavian artery.
pediatricimaging.org • CC-by-nc-sa 4.0
Aberrant
right subclavian artery • Aberrant right subclavian artery - Ganzer Fall bei Radiopaedia
Radswiki T, Aberrant right subclavian artery. Case study, Radiopaedia.org (Accessed on 29 Mar 2023) https://doi.org/10.53347/rID-11153 • CC by-nc-sa 3.0 (modified)
Aberrant
right subclavian artery • Aberrant right subclavian artery - Ganzer Fall bei Radiopaedia
Di Muzio B, Aberrant right subclavian artery. Case study, Radiopaedia.org (Accessed on 29 Mar 2023) https://doi.org/10.53347/rID-22395 • CC by-nc-sa 3.0 (modified)
Aberrant
right subclavian artery • Aberrant right subclavian artery - Ganzer Fall bei Radiopaedia
Di Muzio B, Aberrant right subclavian artery. Case study, Radiopaedia.org (Accessed on 29 Mar 2023) https://doi.org/10.53347/rID-19283 • CC by-nc-sa 3.0 (modified)
Aberrant
right subclavian artery • Aberrant right subclavian artery (ARSA) - Ganzer Fall bei Radiopaedia
Goel A, Aberrant right subclavian artery (ARSA). Case study, Radiopaedia.org (Accessed on 29 Mar 2023) https://doi.org/10.53347/rID-71652 • CC by-nc-sa 3.0 (modified)
Aberrant
right subclavian artery • Aberrant right subclavian artery - Ganzer Fall bei Radiopaedia
Niknejad M, Aberrant right subclavian artery. Case study, Radiopaedia.org (Accessed on 29 Mar 2023) https://doi.org/10.53347/rID-87093 • CC by-nc-sa 3.0 (modified)
Aberrant
right subclavian artery • Aberrant right subclavian artery - Ganzer Fall bei Radiopaedia
Niknejad M, Aberrant right subclavian artery. Case study, Radiopaedia.org (Accessed on 29 Mar 2023) https://doi.org/10.53347/rID-87334 • CC by-nc-sa 3.0 (modified)
Aberrant
right subclavian artery • Aberrant right subclavian artery - Ganzer Fall bei Radiopaedia
Niknejad M, Aberrant right subclavian artery. Case study, Radiopaedia.org (Accessed on 29 Mar 2023) https://doi.org/10.53347/rID-62722 • CC by-nc-sa 3.0 (modified)
Aberrant
right subclavian artery • Aberrant right subclavian artery - Ganzer Fall bei Radiopaedia
Radswiki T, Aberrant right subclavian artery. Case study, Radiopaedia.org (Accessed on 29 Mar 2023) https://doi.org/10.53347/rID-11152 • CC by-nc-sa 3.0 (modified)
A. lusoria in
axial CT-scan. (1) trachea, (2) esophagus, (3) A. lusoria.
Wikipedia • CC BY-SA 3.0
Arteria
lusoria and truncus bicaroticus: a case report. Arteria lusoria originates from the aortic arch, crosses the midline between the spine and the oesophagus to reach the right side.
www.eurorad.org • CC by-nc-sa-4.0
Impressionen
des Ösophagus von dorsal durch eine großvolumige A. lusoria. Die A. lusoria ist nicht die Ursache für die Dysphagie der Patientin.
Wikipedia • CC BY-SA 4.0
Computed
tomography in the evaluation of vascular rings and slings. Aneurysm of an aberrant right subclavian artery. a Axial CT scan shows a large aneurysm with partial thrombosis (arrow) at the origin of an aberrant right subclavian artery in a patient with a left aortic arch. b Coronal CT reformatted image in the same patient shows the partially thrombosed aneurysm (arrow) at the origin of an aberrant right subclavian artery
insightsimaging.springeropen.com • Open Access
Computed
tomography in the evaluation of vascular rings and slings. Left aortic arch with an aberrant right subclavian artery. a Illustration showing the appearances of a left aortic arch (arrow) with an aberrant right subclavian (RSC) artery. The first branch from the arch is the right common carotid (RCC) artery, followed by the left common carotid (LCC) artery and then the left subclavian (LSC) artery. The right subclavian (RSC) artery has an aberrant origin as the last branch originating from the proximal descending thoracic aorta and has a retroesophageal (E) course to reach the right side. b Axial CT scan shows an aberrant right subclavian artery (arrow) originating from the proximal descending thoracic aorta and has a retroesophageal course to reach the right. Posterior indentation and compression of oesophagus are seen. c Coronal MIP image demonstrates the aberrant right subclavian artery (arrow) originating from the proximal descending aorta and reaching the right. Normal left subclavian artery (arrowhead) is also seen. d Coronal reconstructed 3D volume-rendered image shows the aberrant right subclavian artery (arrow) originating from the proximal descending thoracic aorta (*) and coursing to the right behind the oesophagus, which is compressed
insightsimaging.springeropen.com • Open Access
Neuroimaging
assessment in Down syndrome: a pictorial review. Three-dimensional reconstruction of a CT angiography of the supra-aortic trunks of a 49-year-old patient with Down syndrome depicting an aberrant right subclavian artery
insightsimaging.springeropen.com • CC-by-4.0
Arteria
lusoria and truncus bicaroticus: a case report. Three branches originate from the aortic arch: truncus bicaroticus (who gives rise to the right common carotid artery and the left common carotid artery), arteria lusoria and the left subclavian artery.
www.eurorad.org • CC by-nc-sa-4.0
Arteria
lusoria and truncus bicaroticus: a case report. An aberrant right subclavian artery (arteria lusoria) which originates from the aortic arch, crosses the midline between the spine and the oesophagus.
www.eurorad.org • CC by-nc-sa-4.0
Aberrant
right subclavian artery • Aortic dissection and aberrant right subclavian - Ganzer Fall bei Radiopaedia
Gaillard F, Aortic dissection and aberrant right subclavian. Case study, Radiopaedia.org (Accessed on 29 Mar 2023) https://doi.org/10.53347/rID-8935 • CC by-nc-sa 3.0 (modified)
This image
is part of a series which can be scrolled interactively with the mousewheel or mouse dragging. This is done by using Template:Imagestack. The series is found in the category Arteria lusoria - CT - case 001. Arteria lusoria in der axialen Computertomographie. Dieses Bild gehört zu einer Serie, die als Bildstapel durchgeblättert werden kann. Siehe Kategorie.
Wikipedia • CC BY-SA 3.0
Arteria
lusoria in der Computertomographie: links coronare Rekonstruktion mit dem schrägen Verlauf von links unten nach rechts oben, rechts im Bild axialer Schnitt mit Darstellung der Hinterkreuzung von Speise- und Luftröhre.
Wikipedia • CC BY-SA 3.0
This image
is part of a series which can be scrolled interactively with the mousewheel or mouse dragging. This is done by using Template:Imagestack. The series is found in the category Arteria lusoria MRA MIP Case 001. Arteria lusoria in der Magnetresonanz-Angiographie (MRA). Darstellung in der MIP gedreht. Man erkennt die einzelnen Abgänge der Carotiden und Aa. subclaviae.
Wikipedia • CC BY 3.0
Aberrant
subclavian artery in MRI / MRA. Maximum intension projection.
Wikipedia • CC BY-SA 3.0
Bandförmige
Impression der Speiseröhre durch Arteria lusoria. Darunter (Pfeile) Einengung der Speiseröhre durch einen Tumor, der für die Schluckbeschwerden ursächlich ist.
Wikipedia • CC BY-SA 3.0
Aberrant
right subclavian artery • Development of aberrant right subclavian artery (illustration) - Ganzer Fall bei Radiopaedia
Tatco V, Development of aberrant right subclavian artery (illustration). Case study, Radiopaedia.org (Accessed on 29 Mar 2023) https://doi.org/10.53347/rID-52193 • CC by-nc-sa 3.0 (modified)
Aberrant
right subclavian artery • Dysphagia lusoria - aberrant right subclavian artery - Ganzer Fall bei Radiopaedia
Dixon A, Dysphagia lusoria - aberrant right subclavian artery. Case study, Radiopaedia.org (Accessed on 29 Mar 2023) https://doi.org/10.53347/rID-9689 • CC by-nc-sa 3.0 (modified)
Preschooler
with vomiting. AP image from an upper GI exam (above left) shows a left sided aortic arch and an indentation running at an angle from left to right across the upper esophagus. Lateral image from an upper GI exam (above right) shows a posterior indentation across the upper esophagus. Axial CT with contrast of the chest (below) shows an aberrant artery coursing anterior to the vertebral body and posterior to the aerated trachea and collapsed esophagus.The diagnosis was left aortic arch with aberrant right subclavian artery.
pediatricimaging.org • CC-by-nc-sa 4.0
Radiopaedia • CC-by-nc-sa 3.0 • de

Aberrant right subclavian arteries (ARSA), also known as arteria lusoria, are one of the commonest of the aortic arch anomalies.

Epidemiology

The estimated incidence is 0.5-2%.

Clinical presentation

They are often asymptomatic, but around 10% of people may complain of tracheo-esophageal symptoms, almost always as dysphagia, termed dysphagia lusoria.

Pathology

Course

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

  • 80% posterior to the esophagus
  • 15% between esophagus and trachea
  • 5% anterior to the trachea
Associations
  • as can be expected from the embryological development of the artery, the right recurrent laryngeal nerve is usually non-recurrent (that is, enters the larynx directly)
  • aneurysmal dilatation (aberrant subclavian arterial aneurysms) of the proximal portion of an aberrant right subclavian artery can occur, a pouch-like aneurysmal dilatation is called a diverticulum of Kommerell
  • if there is a retro-esophageal course
    • it can get compressed between the esophagus and the vertebra
    • the incidence of stenosis/occlusion in this segment is higher
  • it can be associated with trisomy 21 , trisomy 18 and other chromosomal defects.

Radiographic features

Fluoroscopy

An upper GI contrast study will demonstrate displacement of the contrast-filled esophagus. This displacement by the aberrant vessels produces the so-called bayonet deformity of aberrant right subclavian artery.

CT/MRI

CT and MRI both demonstrate the aberrant branch arising from the distal left aortic arch and coursing rightwards, and can define the relationship between the aberrant artery and the trachea and esophagus.

Complications

The presence of aberrant right subclavian artery poses a substantial risk of life-threatening hemorrhage in patients undergoing surgery like esophagectomy. Moreover, the recurrent laryngeal nerve does not follow the orthodox course which is of importance in thyroid and parathyroid surgeries .

Siehe auch:
und weiter:
Assoziationen und Differentialdiagnosen zu Arteria lusoria:
Anomalien des
Aortenbogens
Wikipedia • CC BY-SA 4.0
dysphagia
lusoria
www.eurorad.org • CC by-nc-sa-4.0
aberrierende
linke Arteria subclavia
www.eurorad.org • CC by-nc-sa-4.0
Kommerell-Divertikel
 
www.eurorad.org • CC by-nc-sa-4.0
rechts
descendierende Aorta mit aberrierender linker Arteria subclavia
pediatricimaging.org • CC-by-nc-sa 4.0
zirkumflexer
retroösophagealer rechter Aortenbogen
insightsimaging.springeropen.com • Open Access