1,063 results on '"aberrant right subclavian artery"'
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102. A Computed Tomography Study on the Prevalence of Lusorian Artery Among Hungarian Adults.
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Shamsodini J and Molnár D
- Abstract
Introduction The aberrant right subclavian artery (ARSA), also called as lusorian artery (LA) is a developmental anomaly that exists in conjunction with a right non-recurrent laryngeal nerve (NRLN) in almost all cases. The average prevalence of such a vascular variation is estimated as 1%, although, studies have reported very different population means. Up to date, there is no available data on the frequency of this pattern in the Hungarian population. It can be treated as an indirect marker of a NRLN. Any preoperative information on the course of the inferior laryngeal nerves can help surgeons reduce the risk of an iatrogenic injury during thyroidectomies, especially in an environment where access to intraoperative neuromonitoring is limited. Objectives The primary aims were to determine the prevalence of an ARSA, predict the existence of an NRLN in the Hungarian population, and provide demographic analysis. Methods A retrospective, computed tomography-based study was carried out. Demographic description and statistical analysis were provided where applicable. Detected anomalous vasculatures were visualized with 3D segmentation, and images were interpreted. Results The imaging database review identified three patients with ARSA out of 686 eligible recordings, resulting in a frequency of 0.437% in the study population. All three patients were female and had a retroesophageal LA. Two of them had a Kommerell's diverticulum. One patient had common carotid arteries with a single origin. Conclusions The frequency of an ARSA and a concomitant NRLN among Hungarians fits into the results of recent meta-analyses. Preoperative assessment of this anomaly may reduce vocal cord complication rates of thyroidectomies., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Shamsodini et al.)
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- 2024
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103. Emergency deep hypothermic circulatory arrest in a 1 year old undergoing cardiac surgery in a Nigerian hospital - anaesthesia and critical care interventions
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Chidiebele Samuel Ikenga, BalSwaroop Sahu, Vincent Okwulehie, and Friday Umeh
- Subjects
deep hypothermic circulatory arrest ,cerebral perfusion ,interrupted aortic arch ,aberrant right subclavian artery ,ventricular septal defect ,patent ductus arteriosus ,Medicine - Abstract
Deep Hypothermic Circulatory Arrest (DHCA) is a technique used to obtain optimal operating conditions while providing cerebral protection. The case report presented a DHCA on an infant that was basically done as an emergency in an attempt to correct a previously unrecognized anomaly. We report a case of a 1 year old that had surgery for Ventricular Septal Defect (VSD) and Patent Ductus Arteriosus (PDA) ligation but following closure was noted to have no pulses on the lower limbs necessitating emergency reopening of the chest. Close Inspection revealed an Interrupted Aortic Arch with aberrant right subclavian artery and pre- surgery PDA supplying both upper and lower limb. DHCA was immediately commenced and the patient cooled to 16°C. The surgeon immediately set out to attach the subclavian artery to the ascending aorta and descending aorta. At the completion of the surgery, the patient was taken to Intensive Care Unit (ICU) for critical care support. She was subsequently discharged after spending a little more than a week in ICU. This procedure is rarely done as an emergency but was instituted in our case in effort to immediately achieve perfusion to the limbs. As the expertise to carry out the procedure is limited, it might be better to develop ways to efficiently ensure the skill set is continually updated.
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- 2020
- Full Text
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104. Aberrant right subclavian artery re-routing for hybrid repair of proximal descending aortic aneurysm
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Tae Yun Kim and Kyung Hwa Kim
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Aberrant right subclavian artery ,Proximal descending aortic aneurysm ,Surgery ,RD1-811 ,Anesthesiology ,RD78.3-87.3 - Abstract
Abstract Background An aberrant right subclavian artery (ARSA) is a relatively prevalent vascular anomaly. What is the most appropriate treatment for thoracic aortic aneurysm combined a non-aneurysmal change ARSA? Case presentation A 52-year-old man was admitted to our institute due to a history of chronic cough, dysphagia and an abnormal chest radiographic finding. Because of his progressive symptoms and large fusiform thoracic aneurysm, we performed the hybrid repair for simultaneous relief of an ARSA causing dysphagia and thoracic aneurysm. Conclusion In case without aneurysm of ARSA, especially in conjunction with approximate thoracic aneurysm, our approach is suitable because the revascularization using the right carotid to subclavian artery re-routing prior to endograft deployment is justified in order to preserve circulation of posterior brain, spinal cord, internal mammary artery and upper limb and to prevent large retrograde type II endoleaks, as well as simplicity and durability.
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- 2018
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105. An unusual Cause of Late-Onset Dysphagia: Aberrant Right Subclavian Artery
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Serdar Aslan and Muzaffer Elmali
- Subjects
aberrant right subclavian artery ,dysphagia lusoria ,late-onset. ,Medicine - Abstract
Dysphagia that develops in the late period due to vascular compression of the esophagus is a rare condition and is known as dysphagia lusoria. The arterial developmental anomalies that occur during embryological development of the branchial arch system are shown as the cause. Most of the cases are asymptomatic, but in 30–40% of the cases, tracheoesophageal symptoms occur. Dysphagia lusoria is diagnosed using barium fluoroscopic examinations and computed tomography. Manometric findings are variable, and age-related esophageal motility changes may contribute to the diagnosis of dysphagia lusoria. In this case report, we aimed to present a case of late-onset dysphagia due to the aberrant right subclavian artery. The patient had dysphagia against solid foods, and the symptoms were controlled with diet modification without the need for surgery.
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- 2019
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106. Type 2 left proatlantal artery with normal left vertebral artery and association with an aberrant right subclavian artery and a bi-carotid trunk.
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Uchino, Akira and Tokushige, Kazuo
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SUBCLAVIAN artery , *BLOOD vessels , *VERTEBRAL artery , *CEREBRAL arteries , *FORAMEN magnum , *COMPUTED tomography - Abstract
Type 2 proatlantal artery (PA) is a rare type of the carotid-vertebrobasilar anastomosis that arises from the external carotid artery and enters the posterior fossa via the foramen magnum (FM). The type 2 PA is usually large and takes a similar course to the occipital artery (OA). The peripheral branch of the OA arises from the distal segment, just proximal to the FM. The ipsilateral vertebral artery (VA) is usually aplastic or hypo-plastic. We diagnosed a case of relatively small type 2 left PA in a patient with a normally developed ipsilateral VA. Furthermore, the patient had an aberrant right subclavian artery associated with a bi-carotid trunk. The combination of these extracranial arterial variations has not been reported in the relevant English language literature. [ABSTRACT FROM AUTHOR]
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- 2022
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107. 二维超声与STIC技术叠加高分辨血流成像诊断早孕期胎儿迷走右锁骨下动脉.
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林冬梅, 黄羽君, 谭莹, 袁鲲, 刘文芬, 徐作峰, and 朱云晓
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SUBCLAVIAN artery , *FETAL ultrasonic imaging , *ULTRASONIC imaging , *FETUS , *PREGNANCY , *TWINS - Abstract
Objective To assess the value of transabdominal real-time 2-D ultrasound and spatio-temporal image correlation (STIC) combined with high-definition flow imaging (HDFI) for detecting fetal aberrant right subclavian artery (RSA) in unselected population during early pregnancy. Methods From November 2018 to September 2019, routine ultrasound was performed on 801 fetuses at 11 to 13 6 gestational weeks. The fetal RSA was observed using both transabdominal 2-D HDFI and STIC-HDFI. The sensitivities, specificities, positive predictive value (PPV) and negative predictive value (NPV) of screening tests were compared between the two methods. Results According to the inclusion criteria and follow-up results, a total of 305 fetuses including 283 singletons and 11 twins were included in this study. Of 14 confirmed aberrant RSA including 12 isolated aberrant RSA and 2 cases with multiple severe malformations, 7 isolated aberrant RSA were detected by both two methods, 11 by 2-D HDFI, and 8 by STIC HDFL The diagnostic sensitivity of 2-D HDFI (78.6%) was significantly higher (P=0.001) than that of STIC-HDFI (57.1%). Combined both methods, the sensitivity (85.7%) was significantly higher than that of STIC-HDFI (P<0.001) without significant difference from that of 2-D HDFI (P=0.193). There was no significant difference in specificity (all 100%), accuracy (98%-99.3%), PPV (all 100%) or NPV (98%-99.3%) between the combined and single methods (P>0.05). Conclusion Real-time transabdominal 2-D ultrasound combined with HDFI and STIC can improve detection of fetal aberrant RSA in the first-trimester pregnancy. [ABSTRACT FROM AUTHOR]
- Published
- 2020
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108. Emergency deep hypothermic circulatory arrest in a 1-year-old undergoing cardiac surgery in a Nigerian hospital - anaesthesia and critical care interventions.
- Author
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Ikenga, Chidiebele Samuel, Sahu, Balswaroop, Okwulehie, Vincent, and Umeh, Friday
- Abstract
Deep Hypothermic Circulatory Arrest (DHCA) is a technique used to obtain optimal operating conditions while providing cerebral protection. The case report presented a DHCA on an infant that was basically done as an emergency in an attempt to correct a previously unrecognized anomaly. We report a case of a 1-year-old that had surgery for Ventricular Septal Defect (VSD) and Patent Ductus Arteriosus (PDA) ligation but following closure was noted to have no palpable peripheral pulses, only carotid pulsation. This necessitated an emergency reopening of the chest. Close inspection revealed an interrupted aortic arch with aberrant right subclavian artery and pre-surgery PDA supplying both upper and lower limb. DHCA was immediately commenced and the patient cooled to 16°C. The surgeon promptly set out to attach the subclavian artery to the ascending aorta and descending aorta. At the completion of the surgery, the patient was taken to Intensive Care Unit (ICU) for critical care support. She was subsequently discharged after spending a little more than a week in ICU. This procedure is rarely done as an emergency but was instituted in our case in effort to immediately achieve perfusion to the limbs. As the expertise to carry out the procedure is limited, it might be better to develop ways to efficiently ensure the skill set is continually updated. [ABSTRACT FROM AUTHOR]
- Published
- 2020
- Full Text
- View/download PDF
109. 胎儿迷走右锁骨下动脉对染色体异常的诊断价值.
- Author
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韩华 and 李建玲
- Abstract
Objective To investigate the clinical significance of aberrant right subclavian artery(ARSA) in the screening of fetal chromosome abnormalities. Methods From January 2017 to May 2018, 4 862 pregnant women were examined by ultrasound before delivery in Xinxiang Central Hospital. A total of 36 fetuses with aberrant right subclavian artery were detected. All fetuses were followed up. The ultrasound images, karyotype results and clinical outcome were summarized. Results All 36 cases of ARSA were detected by three vessels and trachea view. of which 25 cases of simple ARSA fetuses had normal karyotype, all of them were alive and term delivery. The body developed well for 12 months, and no symptoms of respiratory tract and esophageal compression occurred. 11 cases of complex ARSA fetuses were abnormal in cardiac structure and ultrasonic soft index, 9 cases of 21 trisomy, 1 case of 18 trisomy and 1 case of 22qll microdeletion were confirmed by chromosome examination, and 11 cases were terminated pregnancy bb y antenatal consultation. Conclusion ARSA alone has a good prognosiis and do es not increase the risk of aneuploidy. If there are cardiac defects, extracardiacanomalies or multiple abnormal ultrasonic soft indexes, the risk of chromosome abnormalities 1s high. Aberrant right subclavian artery with additional ultrasound findings constitute a strong predictor for fetal chromosome abnormalities. [ABSTRACT FROM AUTHOR]
- Published
- 2020
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110. Endovascular repair of type A aortic intramural hematoma accompanied by aberrant right subclavian artery and Kommerell's diverticulum: a case report.
- Author
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Xiong, Sizheng, Wang, Daoquan, and Li, Jun
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ENDOVASCULAR surgery ,SUBCLAVIAN artery ,DIVERTICULUM ,HEMATOMA ,THERAPEUTICS ,AORTIC dissection - Abstract
Background: The lesions of aberrant right subclavian artery, Kommerell's diverticulum and type A aortic intramural hematoma are rare, and we usually treat them with open surgery. In some cases patients have increased risk to undergo surgery, the experiences of endovascular or medical treatment are limited.Case Presentation: Here we reported a case of a 53-year-old man with these three entities present with chest and back ache and attempted a novel approach, thoracic endovascular aortic repair, in the absence of surgical treatment. The patient lived over 5 years and this case provides initial experience and lesson about the endovascular and medical management of the uncommon and dangerous disease- type A aortic intramural hematoma with aortic congenital malformation.Conclusion: Thoracic endovascular aortic repair with medical treatment may be a potential alternative approach for type A aortic intramural hematoma. [ABSTRACT FROM AUTHOR]- Published
- 2020
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111. Dysphagia Lusoria: Is the Dysmotility Connection Illusory or Real?
- Author
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Coles, Michael and Sharma, Amol
- Subjects
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ESOPHAGEAL motility disorders , *DEGLUTITION disorders , *SUBCLAVIAN artery , *ESOPHAGEAL motility , *THORACIC aorta , *SURGICAL decompression , *CARDIOVASCULAR system abnormalities , *MANOMETERS - Abstract
Dysphagia lusoria is rare embryologic defect of the aortic arch vasculature characterized by an aberrant retro-esophageal course of the right subclavian artery (RSA), comprising a vascular sling. This may manifest clinically with symptoms of dysphagia or reflux. Given the rarity of this pathology, there remains uncertainty regarding the most effective treatment algorithm. Vascular decompression procedure surgery is often used to rectify the aberrant vascular morphology. However, a low percentage of aberrant arteries result in trachea-esophageal symptoms. As such, we suggest (1) one must exclude co-morbid esophageal motility disorders in patients with dysphagia; and (2) aberrant RSA may be a cause of dysphagia, so-called dysphagia lusoria, but represents an unlikely mechanism, since this morphological arrangement typically does not result in a highly constrictive, circumferential vascular ring. It follows, therefore, that directly addressing the esophageal motility issue should take precedence over complex and potentially noncurative vascular procedures directed to the aberrant RSA. However, the presence of marked aneursymal dilation of the aberrant RSA, and/or the presence of a bicarotid (socalled bovine) trunk, would favor vascular repair in the clinical decision-making due to the elevated risk of rupture and more severe esophageal compression in these specific situations. [ABSTRACT FROM AUTHOR]
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- 2020
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112. Incidental finding of an aberrant left pulmonary artery, an aberrant right subclavian artery, and a tracheal bronchus in an adult woman with a meningioma and a history of medulloblastoma.
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Samara, Osama A., Al-Ryalat, Nosaiba T., Ghafel, Afnan N., Saket, Lina Z., Khalafallah, Wessam M., Amarin, Justin Z., and Hadidy, Azmy M.
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SUBCLAVIAN artery , *PULMONARY artery , *BRONCHI , *CONGENITAL disorders , *WOMEN'S health , *CEREBELLAR tumors - Abstract
The aberrant left pulmonary artery and the aberrant right subclavian artery are rare congenital vascular anomalies, and the tracheal bronchus is a rare congenital respiratory anomaly. A 33-year-old female patient, with a history of desmoplastic medulloblastoma, was surgically treated at our hospital for a meningioma. On the second postoperative day, the patient complained of shortness of breath and chest pain. Contrast-enhanced multislice computed tomography was negative for pulmonary embolism, but incidentally revealed all three congenital anomalies. In our report, we detail this exceedingly rare case. [ABSTRACT FROM AUTHOR]
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- 2020
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113. Coronary Angiography in Patients with Arteria Lusoria via Right Radial Access: A Case Series and Literature Review.
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Riangwiwat, Tanawan, Limpruttidham, Nath, Mumtaz, Tayebah, and Blankenship, James C.
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CORONARY angiography , *PERCUTANEOUS coronary intervention , *LITERATURE reviews , *BRACHIOCEPHALIC trunk , *SUBCLAVIAN artery , *INTRAVENOUS catheterization , *CARDIOVASCULAR system abnormalities , *PREDICTIVE tests , *OPERATIVE surgery , *MEDICAL care , *ACQUISITION of data , *CARDIOVASCULAR system , *CORONARY artery disease , *RADIAL artery , *DISEASE complications - Abstract
Transradial is becoming the access of choice for coronary angiography (CAG). Arteria lusoria (AL) poses a challenge for right transradial access because it can cause difficulty in accessing the ascending aorta. Of 18,686 patients who underwent CAG in Geisinger Medical Center from 2012 to 2018, 6 had a diagnosis of AL. Four underwent attempted right radial access, in 3 cases before AL was identified. All were successful, and one patient had successful right transradial percutaneous coronary intervention. CAG and PCI can be successfully performed using right radial access in patients with AL. [ABSTRACT FROM AUTHOR]
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- 2020
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114. Aberrant right subclavian artery with atrial septal defect: Simultaneous repair via median sternotomy.
- Author
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Inam, Hina, Sohail, Abdul Ahad, Asif, Narmeen, and Ahmad, Waris
- Abstract
• Aberrant Right Subclavian artery is also known as Arteria Lusoria. • Rarer congenital malformations of the aortic arch. • Causes compression of the trachea or esophagus causing dysphagia. • May occur simultaneously with an ostium secundum atrial septal defect. • Both conditions repaired simultaneously via Median Sternotomy. Aberrant right subclavian artery, also known as arteria lusoria, is one of the rarer congenital vascular malformations of the left sided aortic arch which arises distal to the left subclavian artery, following a retroesophageal course to the right side causing compression of the trachea or esophagus and resulting in a variety of symptoms most commonly dysphagia. We report a case of a two and a half year old child who was diagnosed as having as having an aberrant right subclavian artery with an ostium secundum atrial septal defect and underwent simultaneous repair of both conditions via a median sternotomy. Aberrant right subclavian artery (ARSA) has a prevalence of 1.8 % and most commonly presents in fourth or fifth decade of life. Various surgical approaches have been described to repair this anomaly over the past years, each with its own limitations and complications. However, the median sternotomy approach provides adequate exposure during division and re-implantation of the vessel and simultaneously allows repair of any intra-cardiac defect. We believe that the best exposure for the correction of aberrant right subclavian artery is via a median sternotomy, especially in pediatric patients associated with other cardiac anomalies. [ABSTRACT FROM AUTHOR]
- Published
- 2020
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115. Molecular Pathways and Animal Models of Semilunar Valve and Aortic Arch Anomalies
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Johnson, Amy-Leigh, Bamforth, Simon D., Rickert-Sperling, Silke, editor, Kelly, Robert G., editor, and Driscoll, David J., editor
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- 2016
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116. The Fetal Heart in Early Pregnancy
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Hernandez-Andrade, Edgar, Patwardhan, Manasi S., and Abramowicz, Jacques S., editor
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- 2016
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117. Aberrant Right Subclavian Artery Aneurysm: A Presentation of Two Cases
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Ömer Özçağlayan, Tuğba İlkem Özçağlayan, Mücahit Doğru, and Bozkurt Gülek
- Subjects
aberrant right subclavian artery ,aneurysm ,contrast-enhanced computed tomography. ,Medicine - Abstract
Aberrant right subclavian artery (ARSA) aneurysm can be an important cause of mortality or potential rupture of the esophagus or trachea. It is important to emphasize that diagnosis of ARSA aneurysm is crucial to avoid fatal complications. Contrast-enhanced computed tomography (CECT) is the best imaging modality to illustrate the necessary details of the anatomy and such complications. The aim of this report was to demonstrate the usefulness of CECT in 2 cases of ARSA aneurysm.
- Published
- 2017
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118. Prenatal diagnosis of aberrant right subclavian artery in an unselected population
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Mi Jin Song, Byoung Hee Han, Young-Hwa Kim, So Young Yoon, Yoo Mi Lee, Hye Su Jeon, and Bo Kyung Park
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Aberrant right subclavian artery ,Aorta, thoracic ,Chromosome aberrations ,Fetal echocardiography ,Prenatal diagnosis ,Ultrasound ,Medical technology ,R855-855.5 - Abstract
Purpose The purpose of this study was to determine the frequency of aberrant right subclavian artery (ARSA) among unselected fetuses and to evaluate its association with chromosomal abnormalities and other congenital anomalies. Methods In all, 7,547 fetuses (gestational age, 20 to 34 weeks) were examined using routine antenatal sonography at our institution between April 2014 and September 2015. The right subclavian artery was assessed using grayscale and color Doppler ultrasonography in the transverse 3-vessel and tracheal view, and confirmed in the coronal plane. Results ARSA was found in 28 fetuses (0.4%). Further, 27 of these 28 fetuses were euploid (96.4%). Trisomy 18 was the only chromosomal anomaly (3.6%) found in the study sample. ARSA was an isolated finding in 23 of the 28 cases (82.1%). In the remaining three cases (10.7%), ARSA was accompanied with extracardiac anomalies. Other cardiac defects were present in three cases (10.7%). Conclusion Isolated ARSA does not seem to be associated with a significantly increased risk of aneuploidy. However, the possibility of fetal karyotyping, which is a more invasive procedure, should be discussed in the light of the overall risk of the fetus.
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- 2017
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119. Successful video-assisted thoracoscopic surgery in prone position in patients with esophageal cancer and aberrant right subclavian artery: report of three cases
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Koji Shindo, Eishi Nagai, Toshinaga Nabae, Toru Eguchi, Taiki Moriyama, Kenoki Ohuchida, Tatsuya Manabe, Takao Ohtsuka, Yoshinao Oda, Makoto Hashizume, and Masafumi Nakamura
- Subjects
Video-assisted thoracoscopic surgery ,Prone position ,Aberrant right subclavian artery ,Nonrecurrent right inferior laryngeal nerve ,Esophageal cancer ,Surgery ,RD1-811 - Abstract
Abstract Background An aberrant right subclavian artery (ARSA) with an associated nonrecurrent right inferior laryngeal nerve (NRILN) is a relatively rare anomaly that occurs at a frequency of 0.3 to 2.0% of the general population. NRILN has been mainly documented in the head and neck region; it has been rarely described in patients with esophageal cancer, especially those undergoing thoracoscopic surgery. Video-assisted thoracoscopic surgery for esophageal cancer (VATS-E) is becoming more widespread as a reliable minimally invasive surgical procedure associated with reduced perioperative complications. Case presentation Herein, we report three cases of esophageal cancer with ARSA and NRILN which underwent successful VATS-E. Case 1, a 53-year-old male who had early stage esophageal cancer was performed VATS-E. Upper gastrointestinal (GI) series showed “Bayonet sign” (T1aN0M0, pStageIA in UICC). Case 2, a 75-year-old male who had advanced esophageal cancer was performed neoadjuvant chemotherapy and following VATS-E. This case had right thoracic duct and “Bayonet sign” on upper GI series (T1bN2M0, pStage IIIA in UICC). Case3, a 72-year-old male who had advanced esophageal cancer was performed neoadjuvant chemotherapy and following VATS-E (T3N2M0, pStageIIIB in UICC). All of these three cases were performed VATS-E and discharged without any complication. Conclusion VATS-E in the prone position is a feasible procedure that can reduce the risk of complications with an enlarged and clear view, and knowledge of this type of anomaly is very important for surgeons who perform esophagectomy.
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- 2017
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120. Aberrant right subclavian artery presenting as tracheoesophagial fistula in a 50-year-old lady: Case report of a rare presentation of a common arch anomaly
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Sayyed Ehtesham Hussain Naqvi, Mohammed Hanif Beg, Shyam Kumar Singh Thingam, and Eram Ali
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Aberrant right subclavian artery ,aspiration pneumonitis ,tracheoesophageal fistula ,Medicine ,Pediatrics ,RJ1-570 ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
A 50-year-old, woman with a 2-year history of progressive dysphagia and 2-month history of chronic cough was referred to our center in a state of generalized sepsis. Provisional diagnosis of carcinoma esophagus with tracheoesophagial fistula was made. Evaluation of the patient revealed an aberrant right subclavian artery with retroesophageal course with compression of the esophagus and trachea with fistulous communication in between. The patient was managed with medical stabilization and with feeding jejunostomy, but she succumbed to underlying severe sepsis. This presentation of aberrant subclavian artery at this advanced age rare and is therefore reported.
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- 2017
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121. Vascular Rings and Slings
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Backer, Carl L., Popescu, Andrada R., Rastatter, Jeffrey C., Russell, Hyde M., Da Cruz, Eduardo M., editor, Ivy, Dunbar, editor, and Jaggers, James, editor
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- 2014
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122. Interrupted Aortic Arch
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Lee, Melissa, d’Udekem, Yves, Brizard, Christian, Da Cruz, Eduardo M., editor, Ivy, Dunbar, editor, and Jaggers, James, editor
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- 2014
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123. Treatment of Dysphagia Lusoria with Supraclavicular Incision in Children: Aberrant Right Subclavian Artery.
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BAHADIR, Kutay, ATES, Ufuk, ERGUN, Ergün, GOLLU, Gülnür, KOKSOY, Cüneyt, YAGMURLU, Aydın, and DINDAR, Hüseyin
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DEGLUTITION disorders , *CHILD patients ,SUBCLAVIAN artery surgery - Abstract
Aberrant right subclavian artery (ARSA) is a rare (0.5-1.8% of the population), usually asymptomatic congenital anomaly. We report the three female patients who were successfully treated by surgery of supraclavicular incision. The median age at the operation time was 15 years old (range: 10-18 years). There were no peroperative and postoperative complication. Ulnar and radial tensions were bilaterally normal rate after surgery. There were no difficulties after the postoperative feeding. It may be suggested that end to side anastomosis of ARSA to carotid artery via supraclavicular incision is a feasible and minimal invasive method for children with dysphagia lusoria. [ABSTRACT FROM AUTHOR]
- Published
- 2019
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124. An unusual case of asymmetrical combined variations of the subclavian and axillary artery with clinical significance.
- Author
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Panagouli, E., Natsis, K., Piagkou, M., Kostare, G., Tsoucalas, G., Venieratos, D., Panagouli, Eleni, Natsis, Konstantinos, Piagkou, Maria, Kostare, Georgia, Tsoucalas, Gregory, and Venieratos, Dionysios
- Abstract
In a Greek Caucasian male cadaver, a combination of the following arterial variations were observed: an aberrant right subclavian artery originating as a last branch of the aortic arch and coursed posterior to the oesophagus, a right non-recurrent laryngeal nerve, an atypical origin of the left suprascapular artery from the axillary artery, an unusual emersion of the lateral thoracic artery from the subscapular artery and a separate origin of the left thoracodorsal artery from the axillary artery. According to the available literature the corresponding incidences of the referred variants are: 0.7% for the aberrant right subclavian artery, 1.6-3.8% for the origin of the suprascapular artery from the axillary artery, 3% for the origin of the left thoracodorsal artery from the axillary artery and 30% for the origin of the lateral thoracic artery from the subscapular artery. Such unusual coexistence of arterial variations may developmentally be explained and has important clinical significance. [ABSTRACT FROM AUTHOR]
- Published
- 2019
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125. Anatomical variation in the right non-recurrent laryngeal nerve reported from studies using pre-operative arterial imaging.
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Polednak, Anthony P.
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LARYNGEAL nerves , *ANATOMICAL variation , *SUBCLAVIAN artery , *INTER-observer reliability , *THYROID gland , *COMPUTED tomography - Abstract
The right non-recurrent (inferior) laryngeal nerve (NRLN) is a rare anatomical variant associated with an arterial anomaly, the aberrant right subclavian artery (ARSA), that is detectable by pre-operative imaging (POI) using computed tomography and/or ultrasound. Most surgical studies have utilized two major types, NRLNs arising near the upper pole of the thyroid gland (type 1), vs. at a lower level (type 2) but with two subtypes defined by relationships to the inferior thyroid artery (ITA). This review found 8 English language surgical studies using POI that reported at least 1 NRLN and had anatomical information; of the 88 right NRLNs, 69.3% were classified as type 2 and 30.7% as type 1. Meta-analysis yielded a weighted proportion of 74.0% for type 2, but with substantial heterogeneity. For a subgroup of 5 POI studies with information on subtypes, 22 (59.5%) of 37 type 2 nerves were type 2a (i.e., running at or above the ITA). Similarly, a separate review of large surgical series without POI found that 60.4% of all 91 type 2 NRLNs were type 2a. The study findings should be relevant to the increasing numbers of anterior neck surgeries including bilateral thyroidectomies. A need was identified for studies on inter-observer reliability (agreement) among surgeons on NRLN types, and on injury rates (and related symptoms) by the type of NRLN. [ABSTRACT FROM AUTHOR]
- Published
- 2019
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126. Coexistence an aberrant right subclavian artery with other congenital anomalies: case report and review of the literature.
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Mrochek, Alexander Gennadievich, Kabak, Sergey Lvovich, Haidzel, Iryna Kazimirovna, Melnichenko, Yuliya Michailovna, and Kalenchic, Tamara Ivanovna
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SUBCLAVIAN artery , *VENA cava superior , *VENTRICULAR septal defects , *HUMAN abnormalities , *HEART failure , *MITRAL valve - Abstract
Aberrant right subclavian artery is the most common aortic arch anomaly that frequently occurs in coexistence with other congenital cardiovascular anomalies. A 32-year-old male patient was hospitalized with ventricular septal defect, chronic heart failure NYHA class III, pulmonary arterial hypertension. Contrast-enhanced multislice computed tomography revealed membranous ventricular septal defect, persistent left superior vena cava, bicuspid aortic valve and aberrant right subclavian artery. Aberrant right subclavian artery was clinically silent and discovered accidentally. The patient underwent heart–lung transplantation due to pronounced, irreversible pulmonary hypertension. This article reports a rare coexistence of aberrant right subclavian artery with other congenital anomalies of the heart and great vessels in living men. [ABSTRACT FROM AUTHOR]
- Published
- 2019
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127. Prevalence and Types of Aortic Arch Variants and Anomalies in Congenital Heart Diseases.
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Tawfik, Ahmed M., Sobh, Donia M., Ashamallah, Germeen A., and Batouty, Nihal M.
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Rationale and Objectives: Aortic arch (AA) variants and anomalies are important to recognize in patients with congenital heart disease (CHD) before surgery or intervention. The aim was to study the prevalence of AA anomalies and variants in patients with CHD compared to a control group. The secondary outcome was to report the associations between common variations of AA and specific types of CHD.Materials and Methods: After institutional review board approval, computed tomography studies of 352 CHD patients and control group of 400 consecutive computed tomography scans of the thorax were evaluated. The AA was assigned to one of seven common types, and their distribution was compared between CHD and control. The distribution of the AA anomalies and variants was evaluated as regard specific types of CHD and the visceroatrial situs.Results: Normal three-vessel branching pattern was the commonest in both groups, but was present in only 50.5% in the CHD compared to 68.5% in the control group, p < 0.00001. Right AA and aberrant right subclavian artery were significantly more common in CHD than control group (18.1% versus 0.25%, p < 0.00001) and (4.5% versus 0.25%, p = 0.0001), respectively. Direct aortic origin of left vertebral artery was insignificantly more common in CHD group (4.2% versus 2.7%, p = 0.258). Brachiobicephalic trunk was significantly more common in control than CHD group (27.7% versus 19.3%, p = 0.007).Conclusion: Normal three-vessel AA was significantly less common in CHD. AA anomalies (right arch and aberrant right subclavian) were more common in CHD than control, while AA variants (brachiobicephalic trunk and direct aortic origin of left vertebral artery) were not. [ABSTRACT FROM AUTHOR]- Published
- 2019
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128. Microarray analysis has no additional value in fetal aberrant right subclavian artery: description of 268 pregnancies and systematic literature review.
- Author
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Sagi‐Dain, L., Singer, A., Josefsberg, S., Peleg, A., Lev, D., Samra, N. Nasser, Bar‐Shira, A., Zeligson, S., Maya, I., Ben‐Shachar, S., Sagi-Dain, Lena, Singer, Amihood, Sagi, Josephsberg, Amir, Peleg, Lev, Dorit, Nasser Samra, Nadra, Bar-Shira, Anat, Zeligson, Sharon, Idit, Maya, and Ben-Shachar, Shay
- Subjects
- *
TRISOMY 18 syndrome , *SUBCLAVIAN artery , *LITERATURE reviews , *META-analysis , *DOWN syndrome , *PREGNANCY - Abstract
Objectives: Fetal aberrant right subclavian artery (ARSA) is a relatively common sonographic finding. Several studies have reported a significant association between ARSA and Down syndrome, as well as 22q11.2 microdeletion. The objective of this study was to assess the risk of abnormal chromosomal microarray analysis (CMA) findings in a large cohort of pregnancies with fetal ARSA as an isolated, as well as a non-isolated, sonographic anomaly. A secondary objective was to review the literature, examining the frequency of chromosomal microarray aberrations in fetuses with isolated ARSA.Methods: Data from all pregnancies referred for invasive testing and CMA due to sonographic diagnosis of fetal ARSA, between 2013 and 2017, were obtained retrospectively from the computerized database of the Israeli Ministry of Health. The rate of clinically significant CMA findings in these fetuses was compared to that in a local control population of 2752 low-risk pregnancies with normal ultrasound and serum screening results. In addition, a literature search was conducted in PubMed, from inception to February 2018, of original studies in the English language describing the frequency and nature of microscopic and submicroscopic aberrations in fetuses with isolated ARSA.Results: Of 246 pregnancies with isolated ARSA that underwent CMA analysis, a clinically significant finding was detected in one (0.4%) pregnancy (trisomy 21). This rate did not differ significantly from that in the control population (P = 0.1574). Of 22 fetuses with non-isolated ARSA, one (4.5%) additional case of trisomy 21 was noted. The frequency of trisomy 21 in this cohort also did not differ from that in the control population (relative risk, 5.5 (95% CI, 0.8-37.6)). The literature search yielded 13 additional relevant papers, encompassing 333 cases of isolated ARSA. Of 579 cases overall (including those of the present study), 13 (2.2%) cases of trisomy 21 were detected, with no cases of 22q11.2 microdeletion.Conclusion: While an association may exist between non-isolated ARSA and Down syndrome, isolated ARSA might better serve as a soft marker for Down syndrome, rather than a routine indication for invasive prenatal testing. Copyright © 2018 ISUOG. Published by John Wiley & Sons Ltd. [ABSTRACT FROM AUTHOR]- Published
- 2019
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129. Anatomical anomalies and variations of main thoracic vessels in dogs: a computed tomography study.
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Sebastian-Marcos, P., Fonfara, S., Borgeat, K., Warren-Smith, C., and Casamian-Sorrosal, D.
- Abstract
Abstract Introduction There is scarce information about the prevalence of anomalies and anatomical variations of the main great thoracic vessels in dogs, particularly in dogs without congenital heart disease. Animals The study included 878 privately owned dogs. Material and methods Computerized tomography (CT) thoracic studies carried out between 2011 and 2014 for a variety of reasons were reviewed. The prevalence of anomalies and anatomical variations of the aorta and vena cava, the arterial branches of the aortic arch and the main branches of the intrathoracic veins in dogs with no evidence of congenital heart disease was evaluated. Poor-quality CTs, CTs with thoracic pathology that impaired visualization or those of young dogs with clinical evidence or suspicion of congenital cardiac disease were excluded. Results Eight hundred two CT studies were analysed. Eight dogs (1%) showed an anatomic anomaly. The most common anomaly was an aberrant retroesophageal right subclavian artery (n = 7, 0.8%). One dog showed a dilated azygos vein secondary to an interrupted vena cava. Three types of branching of the common carotid arteries were observed: both arteries arising at the same point (type I: n = 506/742; 68.2%), separated (type II: n = 212/742; 28.6%) or from a common trunk (type III: n = 24/742; 3.2%). Conclusions Major anatomical variations or anomalies of the main great thoracic vessels in dogs without congenital cardiac disease were rare. An aberrant retroesophageal right subclavian artery was the most common anomaly found. Three slight variations of common carotid artery branching were identified. These findings might be of relevance for surgical or catheterization procedures. [ABSTRACT FROM AUTHOR]
- Published
- 2019
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130. Aberrant right subclavian artery (arteria lusoria) aneurysm with a Kommerell's diverticulum.
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Coşkun, Elif, Altınay, Levent, Tekin, Anıl, and Tütün, Ufuk
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SUBCLAVIAN artery , *DIVERTICULUM , *ANEURYSMS , *OLDER patients - Abstract
The treatment options for aberrant right subclavian artery vary depending on the presence of Kommerell's diverticulum. Because there is a tendency not to report mortalities of these rare cases in the literature, it is hard to reach a conclusion on treatments from the limited data on post-interventional results in these patients. We report our experience with a 67-year old patient with an aberrant right subclavian aneurysm with Kommerell's diverticulum, diagnosed by chance. [ABSTRACT FROM AUTHOR]
- Published
- 2019
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131. Total endovascular repair of a mycotic thoracic aortic aneurysm in a patient with an aberrant right subclavian artery.
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Nakamae, Kosuke, Azuma, Takashi, Yokoi, Yoshihiko, and Niinami, Hiroshi
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- *
THORACIC aneurysms , *SUBCLAVIAN artery , *AORTIC rupture , *ENDOVASCULAR surgery , *PATIENTS' rights , *COMPUTED tomography - Abstract
An aberrant right subclavian artery (ARSA) is a rare arterial anomaly. Although a few cases of total endovascular repair for the ARSA aneurysm have been previously reported, anatomical limitations and the possibility of endoleaks remained. In this case, we created 4 holes on the stent graft for each cervical branch, with reference to the preoperative computed tomography findings. This approach might enable us to repair all types of thoracic aortic aneurysms with ARSA with each anatomical feature. [ABSTRACT FROM AUTHOR]
- Published
- 2021
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132. A Rare Case Of Aberrant Right Subclavian Artery With Type B Aortic Dissection.
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Chellasamy, Rajeev Thilak
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SUBCLAVIAN artery ,AORTIC dissection ,CLINICAL trials ,THORACIC aorta ,SURGICAL complications - Abstract
An aberrant right subclavian artery is a rare aortic arch anomaly where the right subclavian artery arises from the proximal part of the descending thoracic aorta and distal to origin of left subclavian artery. It usually courses behind the esophagus. Type B aortic dissection along with aberrant right subclavian artery is not common. A middle aged man presented with complaints of epigastric pain and on evaluation was found to have aberrant right subclavian artery with type B aortic dissection. A total arch replacement with frozen elephant trunk surgery and an extra-anatomic bypass of right subclavian artery was performed. Type B aortic dissection is more often an incidental finding and its association with aberrant right subclavian artery is unusual. Such association should be identified and treated accordingly to avert clinical complications. [ABSTRACT FROM AUTHOR]
- Published
- 2023
133. Symptomatic aberrant right subclavian artery—A case report and anesthetic implications
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GJ Murukendiran, PrasantaKumar Dash, AspariM Azeez, Nithiyanandhan Palanisamy, and Shivanesan Pitchai
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Anesthesiology and Pain Medicine ,Anesthesiology ,RC666-701 ,dysphagia lusoria ,otorhinolaryngologic diseases ,Diseases of the circulatory (Cardiovascular) system ,RD78.3-87.3 ,General Medicine ,Cardiology and Cardiovascular Medicine ,anesthetic management ,aberrant right subclavian artery - Abstract
Vascular compression of the esophagus by an aberrant right subclavian artery (aRSA) leading to dysphagia is a rare occurrence. There has been a significant advancement in the diagnostic and surgical treatment modalities available for this disorder. Anesthetic management has evolved too and this case report highlights the anesthetic management of a 41-year-old woman presenting with symptoms of dysphagia because of compression of esophagus by an aRSA, who subsequently underwent re-implantation of aRSA into ascending aorta.
- Published
- 2022
134. Aberrant right subclavian artery: case report and literature review
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Nasser, Michel, Petrocheli, Bruna Beatriz, Felippe, Thais Keltke Santos, Isola, Beatriz, Pereira, Beatriz Caroline dos Santos, Sartoreli, Ana Luiza Carvalho, Batista Junior, João Marques, and Brandão, Gustavo Muçouçah Sampaio
- Subjects
artéria lusória ,Kommerell diverticulum ,arteria lusoria ,divertículo de Kommerell ,anomalia vascular ,vascular anomaly ,aberrant right subclavian artery ,artéria subclávia direita aberrante - Abstract
Resumo A artéria subclávia direita aberrante, também conhecida como artéria lusória, é a anomalia do arco aórtico mais comum, ocorrendo entre 0,5 e 1% da população. Possui prevalência em mulheres e normalmente está associada a outras variações anatômicas, como o nervo laríngeo não recorrente, presente em 86,7% dos casos. Em sua maioria, a artéria subclávia direita aberrante não apresenta sintomas. Descrevemos essa alteração em uma paciente de 82 anos, hipertensa e assintomática, que havia sido submetida a uma angiotomografia toracoabdominal para a avaliação de uma dissecção crônica tipo III (DeBakey) associada à dilatação de aorta descendente. No achado, a artéria subclávia direita aberrante apresentava percurso retroesofágico associado a um divertículo de Kommerell. Devido à raridade, realizamos revisão bibliográfica integrativa das bases de dados MEDLINE, UpToDate, LILACS, SciELO e Portal CAPES dos últimos 6 anos e discutimos as alterações anatômicas mais frequentes, a sintomatologia e as condutas terapêuticas adotadas. Abstract The aberrant right subclavian artery, also known as the arteria lusoria, is the most common aortic arch anomaly, occurring in 0.5 to 1% of the population. There is a higher prevalence in women and it is usually associated with other anatomical variations, such as the non-recurrent laryngeal nerve, present in 86.7% of cases. In the majority of cases, the aberrant right subclavian artery causes no symptoms. We describe this anomaly in an 82-year-old, hypertensive, and asymptomatic patient who had undergone a thoracoabdominal angiography to investigate a chronic DeBakey type III aortic dissection with dilation of the descending aorta. The aberrant right subclavian artery followed a retroesophageal course and was associated with a Kommerell diverticulum. In view of its rarity, we conducted an integrative bibliographic review of literature from the last 6 years indexed on the Medline, UpToDate, Lilacs, Scielo, and Portal Capes databases and discuss the most frequent anatomical changes, symptomatology, and therapeutic management adopted.
- Published
- 2023
135. Aberrant right subclavian artery syndrome manifesting as focal tracheomalacia
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Arjun Padmanabhan, Abin Varghese Thomas, and G S K Sandeep
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Aberrant right subclavian artery ,focal ,tracheomalacia ,Diseases of the respiratory system ,RC705-779 - Abstract
Tracheomalacia is one of the rarest etiologies of chronic cough. Herein, we present the case of an elderly woman with chronic cough who on detailed evaluation was found to have focal (localized) tracheomalacia due to compression by an aberrant right subclavian artery (arteria lusoria). The absence of dysphagia in this patient also deserves particular mention.
- Published
- 2017
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136. Right vertebral artery arising from the right common carotid artery without association with an aberrant right subclavian artery and entering the C3 transverse foramen
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Kazuo Tokushige and Akira Uchino
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Aortic arch ,medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,Aberrant right subclavian artery ,Anatomy ,Pathology and Forensic Medicine ,Right Common Carotid Artery ,medicine.artery ,Orthopedic surgery ,cardiovascular system ,medicine ,Foramen ,Right vertebral artery ,Radiology, Nuclear Medicine and imaging ,Surgery ,cardiovascular diseases ,business ,Computed tomography angiography - Abstract
The right vertebral artery (VA) rarely arises from the right common carotid artery (CCA); however, the majority of anomalous right VAs are seen in combination with an aberrant right subclavian artery (SA). Independent (or isolated) right VA of the right CCA origin is extremely rare, with only a few cases reported previously. We herein report an additional case diagnosed incidentally using computed tomography angiography. This patient had a left VA arising from the aortic arch between the origins of the left CCA and left SA. The bilateral VAs took an anterior course and entered the C3 transverse foramina, at an extremely high level.
- Published
- 2021
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137. Aberrant right subclavian artery: embryology, prenatal diagnosis and clinical significance
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Ricardo Palma-Dias, Rachel Annetta, Edward O’Mahony, and Debbie Nisbet
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medicine.medical_specialty ,Radiological and Ultrasound Technology ,business.industry ,Embryology ,medicine ,Aberrant right subclavian artery ,Radiology, Nuclear Medicine and imaging ,Clinical significance ,Prenatal diagnosis ,Radiology ,business - Abstract
Introduction The right subclavian artery normally arises as the first vessel from the brachiocephalic trunk. An aberrant right subclavian artery (ARSA) arises directly from the aortic arch and crosses behind the trachea towards the right arm. This variant occurs in approximately 1–2% of the population; however, the frequency increases in individuals with chromosomal abnormalities such as trisomy 21 and 22q11.2 microdeletion. Prenatal identification of ARSA therefore has a role in screening for such conditions. Methods Databases were searched for studies reporting the prenatal ultrasound evaluation of ARSA and its frequency in normal fetuses and in those with chromosomal abnormalities. Results A total of 23 studies were evaluated. Feasibility for the ultrasound evaluation of ARSA was 85–95%. The sonographic detection of ARSA is best in the three-vessel trachea view; however, sagittal and coronal imaging of the aortic arch may be useful. ARSA in isolation was not found to be associated with chromosomal abnormalities. The prevalence of ARSA in chromosomally abnormal fetuses was up to 24-fold higher than in normal fetuses, but the majority of chromosomally abnormal fetuses with ARSA had additional abnormal ultrasound findings, particularly cardiac abnormalities. Conclusions The prenatal detection of ARSA is a clinically useful prenatal marker for chromosomal abnormalities. In isolation, it is unlikely to be associated with pathogenic genetic variants. The ultrasound diagnosis of ARSA should prompt meticulous assessment of associated abnormalities. Invasive diagnostic testing should be offered to patients with non-isolated ARSA or in the presence of non-reassuring screening results or other risk factors.
- Published
- 2021
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138. Arteria subclavia derecha aberrante: a propósito de un caso pediátrico
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Carlos Alba, Evens Chong, Yina Yavel Samudio, and Humberto Serrud
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Aortic arch ,medicine.diagnostic_test ,business.industry ,Aberrant right subclavian artery ,General Medicine ,Dysphagia ,Asymptomatic ,Extrinsic compression ,medicine.anatomical_structure ,medicine.artery ,Pulmonary artery ,medicine ,medicine.symptom ,Esophagus ,business ,Nuclear medicine ,Computed tomography angiography - Abstract
Los anillos vasculares son anomalías anatómicas que ocurren durante el desarrollo embrionario del arco aórtico, sus ramas y de la arteria pulmonar. Estas estructuras vasculares pueden conducir a grados variables de sintomatología respiratoria y/o digestiva debido a la formación de un anillo completo o parcial que comprime la tráquea y/o el esófago. La arteria subclavia derecha aberrante es la anomalía más común del arco aórtico, con una incidencia reportada entre 0.5 a 2.5%. Generalmente es asintomática, sin embargo, la disfagia es el síntoma más frecuente porque en la mayoría de los casos transcurre detrás del esófago. El diagnóstico puede ser incidental en casos asintomáticos o como resultado del estudio de síntomas digestivos y/o respiratorios persistentes o recurrentes. Los pacientes sintomáticos requieren intervención quirúrgica. Describimos el caso de una paciente de 3 meses de edad con arteria subclavia derecha aberrante. El esofagograma mostró compresión extrínseca del esófago, y la angiotomografía computada confirmó el diagnóstico. La corrección quirúrgica se realizó exitosamente.
- Published
- 2021
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139. Arteria lusoria dissection with mediastinal hematoma as a complication of a transradial coronary catheterization: Case report and literature review.
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Serra, Raffaele, Rocca, Tiberio, Traina, Luca, Licastro, Noemi, Ielapi, Nicola, and Gasbarro, Vincenzo
- Abstract
• Aberrant right subclavian artery (ARSA), or arteria lusoria is the most common embrologic anomaly of the aortic arch. • The ARSA arises after the origin of the left subclavian artery and then reaches the posterior mediastinum. • The presence of ARSA is generally asymptomatic, but may cause complications, during some endovascular procedures. • Prompt diagnosis and treatment is required to avoid more dreadful complications. Aberrant right subclavian artery (ARSA), or arteria lusoria is the most common embrologic anomaly of the aortic arch. It is generally asymptomatic and incidentally diagnosed during a radiological exam or procedure. Here, we report a case of ARSA incidentally diagnosed and injured (dissection with mediastinal hematoma) during a right transradial coronary angiography in a 83 years old female patient. The patient underwent prompt hybrid procedure with the isolation of the right humeral artery from where we positioned a GORE® VIABAHN® 9 × 100 mm endoprosthesis. The procedure was successful with optimal results at early and long term follow up. Sometimes, a dissection of the ARSA may occur, especially for excessive manipulation during endovascular procedures, and when such complication happens it should be promptly treated as it can be life-threatening. If transradial catheterization during coronary angiography becomes particularly difficult, requires longer time, or the guide wire enters in the descending aorta, particularly attention should be paid, as dreadful complications such as dissection or lesion may happen and prompt treatment is required. [ABSTRACT FROM AUTHOR]
- Published
- 2020
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140. Aneurysm of an Aberrant Right Subclavian Artery (Kommerell)-A Rare Phenomenon.
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Kumar, Krishna, Safri, Lenny Suryani, Huei, Tan Jih, Chor Lip, Henry Tan, Md Idris, Mohamad Azim, and Harunarashid, Hanafiah
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- *
SUBCLAVIAN artery , *THORACIC aorta , *BRACHIOCEPHALIC trunk , *ANEURYSMS , *DIVERTICULUM - Abstract
The aberrant right subclavian artery (ARSA) is a rare congenital variant of the aortic arch. When there is present of this aberrant anatomy, the brachiocephalic trunk is usually absent and the right subclavian artery arises as the fourth large arteries from the arch of the aorta. When the ARSA arises from a diverticulum of the distal aortic arch or descending aorta, it is termed as Kommerell aneurysm . Herein, we present a 51 years old man presented with neck pain due to cervical spondylosis. Pre-operative chest x-ray revealed a widened mediastinum. Further computed tomography (CT) of the thorax revealed Kommerell aneurysm of 2.5cm in diameter which does not resulted in any symptoms. We discussed the clinical implications and management of this rare entity in the report. [ABSTRACT FROM AUTHOR]
- Published
- 2020
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141. Thoracic endovascular aortic repair for type B aortic dissection with aberrant right subclavian artery: a single-center retrospective study.
- Author
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Zeng Y, Yuan P, and He Q
- Abstract
Objective: To evaluate the outcomes of thoracic endovascular aortic repair (TEVAR) for type B aortic dissection (TBAD) with aberrant right subclavian artery (ARSA)., Methods: A retrospective analysis was conducted on patients with TBAD and ARSA who underwent TEVAR between the period of January 2017 and December 2022. Patient demographics, computed tomography angiography (CTA) measurements, surgical procedures, and postoperative outcomes were reviewed., Results: A total of 9 patients (6 males and 3 females) were included in the study. 4 ARSA were reconstructed, 3 by periscope technique and 1 by in vitro fenestration technique. 3 left subclavian arteries (LSA) were reconstructed, 1 by the chimney technique and 2 by the single-branched stent technique. 2 patients underwent reconstruction of both ARSA and LSA. The overall technical success rate was 100%, with no occurrences of stroke, paraplegia, or mortality within 30 days. 1 patient experienced immediate type Ia endoleak, which resolved after 3 months. 1 patient developed weakness in the right upper limb, while 1 patient presented mild subclavian steal syndrome (SSS); both cases showed recovery during follow-up. The average follow-up duration was 35.6 ± 11.1 months, during which no reinterventions, deaths, or strokes were observed., Conclusion: Our limited experience involving 9 patients demonstrates that early and mid-term outcomes of TEVAR for the treatment of TBAD with ARSA are satisfactory., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (© 2023 Zeng, Yuan and He.)
- Published
- 2023
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142. Complex Hybrid Repair of an Aberrant Right Subclavian Artery With Rapidly Developing Kommerell's Diverticulum.
- Author
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Kavaliunaite E, Kjeldsen BJ, Midtgaard A, and Akgul C
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Introduction: An aberrant right subclavian artery (ARSA) is an aortic anomaly that, in some cases, can be complicated with Kommerell's diverticulum (KD) at the origin of the ARSA. Progression and rupture of KD are associated with high mortality. Timely intervention is therefore required; however, there are no clinical guidelines for the most suitable intervention., Report: A 50 year old, previously healthy, male patient developed dysphagia. He was diagnosed with an aberrant right subclavian artery and KD. The KD increased in size from 4 - 7 cm within 2 months. He underwent single stage hybrid aortic repair involving an aortic valve replacement, total aortic arch debranchment, two thoracic endovascular aortic repair stents, and subclavian plugs. He developed a stroke during the post-operative period; however, all neurological symptoms had disappeared at 6 months and computed tomography showed no endoleaks and all supraortic vessels were open., Discussion: Literature on KD is limited; therefore, there is no consensus on KD treatment. Increasing awareness of rapidly developing KD will add to current knowledge of the disease. One stage cardiac and non-cardiac surgery was successfully performed with no long term complications., (© 2023 Published by Elsevier Ltd on behalf of European Society for Vascular Surgery.)
- Published
- 2023
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143. Aberrant Right Subclavian Artery Complicated by Acquired Hemophilia A and a Subclavian Artery-Esophageal Fistula after Traumatic Injury.
- Author
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Hirayu N, Fukuda M, Nabeta M, and Takasu O
- Abstract
An aberrant right subclavian artery (ARSA) is a rare developmental anomaly wherein the right subclavian artery arises from the descending aorta as a fourth branch of the aortic arch. We present the case of ARSA in an 81-year-old woman who was injured in a motorcycle accident. The patient had a history of asymptomatic cerebral infarction, type 2 diabetes mellitus, and rheumatoid arthritis. She was diagnosed with spleen and liver injury, left renal injury, along with fractures in the rib, pelvic, vertebrae, and right tibia. On the 3
rd hospitalization day, activated partial thromboplastin time (APTT) prolongation was observed, followed by sudden massive hematemesis and shock on the 39th day. We indicate sudden hematemesis and ARSA bleeding as the cause. We performed compression with a Sengstaken-Blakemore tube and coil embolization for hemostasis. Our findings show that the bleeding was mainly caused by nasogastric tube compression, prolonged APTT, and acquired hemophilia A., Competing Interests: There are no conflicts of interest., (Copyright: © 2023 Journal of Emergencies, Trauma, and Shock.)- Published
- 2023
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144. Frozen Elephant Trunk in Right Aberrant Subclavian Artery
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Antonino Costantino, Ciro Amodio, Carlo Mariani, Davide Pacini, and Luca Di Marco
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Pulmonary and Respiratory Medicine ,Aortic dissection ,Aortic arch ,Elephant trunks ,business.industry ,Aberrant right subclavian artery ,Anatomy ,Chest pain ,medicine.disease ,Aberrant subclavian artery ,medicine.artery ,Cardiac surgery department ,Ascending aorta ,cardiovascular system ,medicine ,Surgery ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business - Abstract
Aberrant right subclavian artery (ARSA) is a relatively rare congenital anomaly of the aortic arch. A 74-year-old woman was referred to our Cardiac Surgery Department for chest pain. Angio-CT scan showed an acute aortic dissection and revealed an ARSA routed behind the trachea. We performed supra-coronary ascending aorta and total arch replacement with Frozen Elephant Trunk (FET) technique. The ARSA was then termino-terminal anastomosed to one branch of the Thoraflex arch graft. Postoperative CT-scan indicated a successful reconstruction of the aortic arch, proving the open stent-grafting technique as a useful and effective approach for aortic disease with ARSA.
- Published
- 2022
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145. Variaciones anatómicas del arco aórtico: Reporte de caso y revisión de la bibliografía.
- Author
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Loccisano, Matías H., Bevacqua, Robertino, and Damonte, Marcelo
- Abstract
Introduction: Variations of the aortic arch are anatomically interesting, although they acquire greater interest when their presentation justifies some type of symptoms. The origin and path of vessels that originate in the aortic arch are not always the same. The aim of this paper is to report a case of lusory artery and to describe the anatomical variants of the aortic arch reported in the literature. Case report: We present a female patient, 49 years old, who consulted for 6 months dysphagia. A neck and chest tomography with intravenous contrast was requested. It demonstrate an aberrant subclavian artery. Discussion: Clinically, aberrant subclavian artery usually presents asymptomatically. We could summarize the different presentation variants according to the number of vessels that originate in the aortic arch. In this way, the aortic arch can give rise to two (18%), three (75%) or up to four (7%) vessels. The lusory artery is a rare but probable variant of presentation. Although most are asymptomatic, dysphagia is the most frequent symptom. [ABSTRACT FROM AUTHOR]
- Published
- 2018
146. Association of variant arch anatomy with type B aortic dissection and hemodynamic mechanisms.
- Author
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Shalhub, Sherene, Schäfer, Michal, Hatsukami, Thomas S., Sweet, Matthew P., Reynolds, Jason J., Bolster, Ferdia A., Shin, Susanna H., Reece, T. Brett, Singh, Niten, Starnes, Benjamin W., and Jazaeri, Omid
- Abstract
Abstract Objective Congenital aortic arch variations are more common in patients with thoracic aortic disease for reasons unknown. Additionally, little is understood about their relation to type B aortic dissections (TBAD) specifically. We investigated the prevalence of variant aortic arch anatomy in patients with TBAD compared with controls. To understand the implications of how variant aortic arch anatomy may contribute to degenerative aortic disease, we compared flow hemodynamics of three variations of aortic arches using four-dimensional flow magnetic resonance imaging (4D flow MRI). Methods Arch anatomy on computed tomography imaging was reviewed and compared between patients with TBAD and age/sex-matched controls free of aortic pathology. Arch variants were defined as follows: common origin of innominate and left common carotid artery (bovine arch), aberrant right subclavian artery, and right-sided aortic arch. Demographics, TBAD characteristics, and follow-up data were abstracted. Patients with TBAD with variant and conventional aortic arches were compared. Additionally, three matched healthy controls with conventional, bovine, and aberrant right subclavian artery arches underwent 4D flow MRI evaluation to assess if there were differences in flow patterns by arch type. Indices of regional hemodynamic wall sheer stress were compared. Results Computed tomography scans of 185 patients with TBAD (mean age, 58.1 ± 12.4 years; 72.4% males; 71.4% Caucasian) and 367 controls (mean age, 62.5 ± 13.4 years; 67% males; 77.9% Caucasian) were reviewed. Variant arch anatomy was more prevalent in patients with TBAD (40.5% vs 24.5%; P <.001). In patients with TBAD, there were no differences in the mean age of presentation and descending thoracic aorta diameter among those with variant or conventional arch anatomy. Patients with TBAD with variant arch anatomy had a higher percentage of dissection related thoracic aortic repairs (54.7% vs 33.6%; P =.004) with repairs occurring predominantly in the acute phase. 4D flow MRI demonstrated a higher systolic wall shear stress along the inner curve of the bovine arch compared with the conventional aberrant right subclavian artery arches. Conclusions Variant aortic arch anatomy is significantly more prevalent in patients with TBAD. patients with TBAD with variant arch anatomy had a higher percentage of dissection-related aortic repair. Preliminary 4D flow MRI data show differences in hemodynamic flow patterns between variant and conventional arches. Studies of long-term outcomes based on arch anatomy may offer additional insight to TBAD genesis and possibly influence management decisions. [ABSTRACT FROM AUTHOR]
- Published
- 2018
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147. Incidental findings on cervical spine computed tomography scans: overlooked and unimportant?
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Beheshtian, Elham, Sahraian, Sadaf, Yousem, David M., and Khan, Majid K.
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DIAGNOSIS , *COMPUTED tomography , *DOCUMENTATION , *HEAD tumors , *NECK tumors , *SUBCLAVIAN artery , *TUMORS , *DISEASE incidence , *RETROSPECTIVE studies , *DESCRIPTIVE statistics ,CERVICAL vertebrae radiography ,CAROTID artery stenosis - Abstract
Purpose: Imaging of the cervical spine for trauma or degenerative disease includes multiple areas of the head and neck that may harbor incidental findings. We sought to determine the incidence of common “incidentalomas” on cervical spine CT scans, their importance, and how often these lesions are mentioned in reports.Methods: We retrospectively reviewed the cervical spine CTs and reports of all patients scanned between October 2017 and January 2018 for Tornwaldt cysts (TC), thyroglossal duct cysts and remnants (TGDC), laryngoceles (LC), pharyngoceles (PC), carotid artery calcified stenosis (CACS), and aberrant right subclavian arteries (ARSA). Descriptive statistics were performed, and the incidence of cancers (in PC and LCs) and strokes (in high-grade carotid stenosis) was assessed.Results: Among 2116 patients, the incidences of findings were TC 6.6% (138/2100), TGDC 6.3% (122/1770), LC 9.4% (197/2100), PC 6.4% (135/2100), CACS 4.7% (100/2114), and ARSA 0.86% (18/2097). Of the 2116 patients studied, 600/2116 (28.3%) had at least one incidental finding. Only 2.9% (20/701) of incidentalomas were mentioned in the official reports.Conclusion: Cervical incidentalomas vary in rates from ARSA (0.86%) to LC (9.4%). They are rarely mentioned in radiologists’ reports. Whether improved vigilance and reporting of these incidentalomas would benefit patient care should be explored. [ABSTRACT FROM AUTHOR]
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- 2018
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148. IMAGING DIAGNOSIS—COMPUTED TOMOGRAPHIC ANGIOGRAPHY CHARACTERISTICS OF MULTIPLE VASCULAR ANOMALIES IN A SENIOR DOG WITH LATE‐ONSET REGURGITATION.
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Yoon, Hakyoung, Kim, Jaehwan, Kwon, Gi Bum, Lim, Jin Hyuk, and Eom, Kidong
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Abstract: A 10‐year‐old dog weighing 3.4 kg presented with intermittent regurgitation. Esophagography revealed that the thoracic esophagus was compressed dorsally at the region of the fourth intercostal space and segmentally dilated from the second to third intercostal region. Three‐dimensional computed tomographic (CT) angiography confirmed a suspected vascular ring anomaly and also revealed multiple other vascular anomalies. These included aberrant right subclavian artery, absence of bilateral external jugular veins, right‐gastric caval shunt, and a completely duplicated caudal vena cava. Findings supported the use of thoracic CT angiography to rule out additional vascular malformations in dogs with suspected vascular ring anomaly. [ABSTRACT FROM AUTHOR]
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- 2018
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149. Non-Recurrent Laryngeal Nerve and Concurrent Vascular Variants: A Review.
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Bakalinis, Emmanouil, Makris, Ioannis, Demesticha, Theano, Tsakotos, Georgios, Skandalakis, Panagiotis, and Filippou, Dimitrios
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LARYNGEAL nerves , *SUBCLAVIAN artery , *CAROTID artery , *SITUS inversus , *THORACIC aorta - Abstract
Objective. The purpose of this paper is to review the current data on the coexistence of non-recurrent laryngeal nerve (RLN) and vascular variations. Methods. A systematic literature search was conducted on MEDLINE for case reports, original articles and reviews regarding the presence of non-RLN and coexisting vascular variants. Results. From the literature search, 104 cases of non-RLN with confirmed vascular variants were reported. More specifically, 97.7% (n=101) of cases involved a right and 2.3% (n=3) a left non-RLN. The most common concurrent vascular variant reported with a right non-RLN was an aberrant right subclavian artery (97%; n=98). One case report (0.9%) of an intrathyroidal right common carotid artery was noted and 2 cases (1.9%) were associated with normal vascular anatomy. Furthermore, all 3 cases of a left non-RLN were associated with a right aortic arch, while 2 of them were also accompanied with situs inversus. Conclusions. The presence of vascular variations of the great vessels must prompt the surgeon to search for a non-RLN. Intraoperative neuromonitoring increases the detection rate of non-RLN. Further research is required to determine anatomic landmarks for the perioperative identification of a non-RLN, allowing its protection from potential injury. [ABSTRACT FROM AUTHOR]
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- 2018
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150. Absent right common carotid artery associated with aberrant right subclavian artery.
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Uchino, Akira, Uwabe, Kazuhiko, and Osawa, Iichiro
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Rarely, the external and internal carotid arteries arise separately from the brachiocephalic trunk and right subclavian artery (SA) or the aortic arch and reflect the absence of a common carotid artery (CCA). We report a 45-year-old man with absent right CCA associated with aberrant right SA, an extremely rare combination, diagnosed by computed tomography (CT) angiography during follow-up for postoperative aortic dissection. Retrospective careful observation of preoperative postcontrast CT revealed the absent right CCA. Previously reported arch variations associated with absent CCA include cervical aortic arch, double aortic arch, and right aortic arch. [ABSTRACT FROM AUTHOR]
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- 2018
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