Aberrant subclavian artery

Anatomical variant of the subclavian artery

Aberrant Subclavian Artery

An aberrant subclavian artery is a rare anatomical variant of the subclavian artery, which is one of the major arteries supplying blood to the upper limb. This condition is also known as "arteria lusoria" and is the most common congenital vascular anomaly of the aortic arch.

Anatomy

In a typical anatomical configuration, the subclavian arteries branch off from the brachiocephalic trunk on the right side and directly from the aortic arch on the left side. However, in the case of an aberrant subclavian artery, the right subclavian artery arises as the last branch of the aortic arch, distal to the left subclavian artery. It then courses behind the esophagus to reach the right arm.

Embryology

The aberrant subclavian artery results from the abnormal regression of the fourth aortic arch during embryonic development. Normally, the right fourth aortic arch contributes to the formation of the right subclavian artery. In the case of an aberrant subclavian artery, the right fourth aortic arch regresses, and the artery develops from the right seventh intersegmental artery, leading to its aberrant course.

Clinical Significance

While many individuals with an aberrant subclavian artery are asymptomatic, some may experience symptoms due to compression of surrounding structures. This condition can lead to dysphagia (difficulty swallowing) when the artery compresses the esophagus, a condition known as "dysphagia lusoria." Other potential symptoms include chest pain, cough, and dyspnea (difficulty breathing).

Diagnosis

The diagnosis of an aberrant subclavian artery is often made incidentally during imaging studies such as computed tomography (CT) or magnetic resonance imaging (MRI) performed for other reasons. Barium swallow studies can also reveal the characteristic indentation on the esophagus caused by the aberrant artery.

Treatment

Treatment is generally not required for asymptomatic individuals. However, in symptomatic cases, surgical intervention may be necessary. Surgical options include revascularization procedures to reposition the artery or relieve compression on the esophagus.

Related Pages

• Subclavian artery
• Aortic arch
• Dysphagia
• Vascular anomalies