7 Aberrant Right Subclavian Artery

CASE 7


image Clinical Presentation


Asymptomatic 42-year-old man


image Radiologic Findings


Coned-down PA (Fig. 7.1) and lateral (Fig. 7.2) chest radiographs demonstrate a left aortic arch and a tubular opacity (asterisk) that arises from its superior aspect, projects over the tracheal lumen, and courses obliquely toward the right upper extremity (Fig. 7.1). Note the presence of an accessory azygos fissure. The lateral radiograph (Fig. 7.2) demonstrates a soft-tissue opacity (double asterisk) that produces mass effect on the dorsal trachea. Contrast-enhanced chest CT (mediastinal window) (Figs. 7.3, 7.4) demonstrates an aberrant right subclavian artery (arrow) (Fig. 7.3) that arises from a diverticulum of Kommerell (arrowhead) (Fig. 7.4).


image Diagnosis


Aberrant Right Subclavian Artery


image Differential Diagnosis


None



image


Fig. 7.1



image


Fig. 7.2




image


Fig. 7.3



image


Fig. 7.4 (Images 7.1–7.4 are courtesy of Maysiang Lesar, MD, National Naval Medical Center, Bethesda, Maryland.)


image Discussion


Background


An aberrant right subclavian artery arises as the last branch off a left-sided aortic arch and courses obliquely and superiorly behind the trachea and esophagus to resume its normal course. It is typically an isolated anomaly, represents one of the most common aortic arch branching anomalies, and affects up to 0.5% of the population, with a reported prevalence of 0.4–2%.


Etiology

Only gold members can continue reading. Log In or Register to continue

Stay updated, free articles. Join our Telegram channel

Jan 14, 2016 | Posted by in RESPIRATORY IMAGING | Comments Off on 7 Aberrant Right Subclavian Artery

Full access? Get Clinical Tree

Get Clinical Tree app for offline access