1,063 results on '"aberrant right subclavian artery"'
Search Results
152. Morphometry of the aortic arch and its branches. A computed tomography angiography-based study
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Mariana Tapia-Nañez, Santos Guzmán-López, Ricardo Pinales-Razo, G A Landeros-Garcia, Bernardo Alfonso Fernandez-Rodarte, Alejandro Quiroga-Garza, M. A. Sada-Treviño, and Rodrigo Enrique Elizondo-Omaña
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Male ,Aortic arch ,Histology ,medicine.diagnostic_test ,Computed Tomography Angiography ,business.industry ,Vertebral artery ,Cardiovascular Abnormalities ,Subclavian Artery ,Aberrant right subclavian artery ,Aorta, Thoracic ,Anatomy ,Common trunk ,Ostium ,Statistical significance ,medicine.artery ,medicine ,Humans ,Female ,Arch ,business ,Retrospective Studies ,Computed tomography angiography - Abstract
Background: The current study aims to determine the prevalence of variations of the aortic arch using computed tomography angiography (CTA), as well as morphometries and gender correlations. Materials and methods: A retrospective, transverse, observational and descriptive study of 220 CTA was performed. The branching pattern, most cranial vertebral level of the aortic arch, area of the proximal, middle and distal segments of the arch, area of each branch, and the path of atypical arteries were recorded. Results were analysed and stratified by gender. Results: The typical aortic arch branching pattern was present in 77.7% without statistical significance between genders. The most common variant was a two-branch pattern with a common trunk and a left subclavian (13.6%), followed by a typical branching pattern with an added left vertebral artery (7.3%). T3 was the most frequent cranial level (32.3%), followed by T2–T3 (26.8%), and T3–T4 (23.2%). The mean areas of the aortic arch were 685.5 ± 183.9, 476.1 ± 124.1, and 445.0 ± 145.1 mm2 for the proximal, middle and distal segments, with statistical difference between men and women in the middle and distal segments. Three paths of atypical arteries were identified: bifurcated vertebral artery (0.5%), aberrant right subclavian artery (0.5%), and left subclavian ostium obstruction (0.5%). Conclusions: Mexican population has one of the highest prevalence of variations in the aortic arch branching pattern. The high probability of finding these should be taken into consideration when assessing patients. A standardised classification method would contemplate future un-reported findings, without causing confusion by the different numbers assigned by each author.
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- 2021
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153. Interdisciplinary Management of a Perforated Aneurysmal Arteria Lusoria: A Case Report
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Mina Rouman, Alexander Petrovitch, Eva-Maria Gey, and Thomas Kuntze
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arteria lusoria ,aberrant right subclavian artery ,aneurysm ,Surgery ,RD1-811 - Abstract
Abstract Background An aberrant right subclavian artery (RSA) or arteria lusoria is the most common congenital abnormality of the aortic arch with an incidence of 0.3 to 3.0%. Case Description We report a case of a perforated aneurysmal aberrant RSA, managed using a hybrid approach. Conclusion In emergency cases with acute bleeding, we recommend an endovascular approach to avoid the lethal sequel of arterial leakage. Whenever possible, the pulsatile blood flow to the right arm should be restored. Management should be tailored to the nature of the aneurysmal aberrant RSA, patient's comorbidities, and concomitant lesions.
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- 2017
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154. Antenatal dönemde izole aberran sağ subklavyen arter gözardı edilmeli mi? Bir yönetim ikilemi
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Süleyman Cemil Oğlak, Mustafa Behram, Sema Süzen Çaypınar, Salim Sezer, Aytul Corbacioglu Esmer, and Tıp Fakültesi
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Prenatal Tanı ,medicine.medical_specialty ,Down syndrome ,Down Sendromu ,Turner Sendromu ,Right subclavian artery ,Turner Syndrome ,Prenatal diagnosis ,Prenatal Diagnosis ,DiGeorge syndrome ,Turner syndrome ,Medicine ,Clinical Investigation ,Gynecology ,Fetus ,Digeorge Syndrome ,Digeorge Sendromu ,business.industry ,Obstetrics and Gynecology ,Aberrant right subclavian artery ,medicine.disease ,Down Syndrome ,Aberrant Right Subclavian Artery ,business ,Trisomy ,Aberran Sağ Subklavyen Arter - Abstract
Objective: To investigate the frequency and types of chromosomal abnormalities in fetuses with the aberrant right subclavian artery (ARSA) and to evaluate its association with other ultrasonographic findings. Materials and Methods: In all, 11,666 fetal anatomic surveys were performed between March 2014 and March 2020. The cases diagnosed as ARSA were examined. Accompanying ultrasound findings and chromosomal abnormalities were collected. Results: ARSA was detected in 140 fetuses (1.2%). The ARSA appeared isolated in 47.1% (66/140) of cases and the remaining 52.9% (74/140) of cases were associated with cardiac or extracardiac malformations and soft markers. Chromosomal abnormalities were detected in 17.8% (25/140) of all cases. Trisomy 21 was the most common chromosomal anomaly with a prevalence of 11.4% (16/140). The corresponding rate was 3% (2/66) and 18.9% (14/74) for isolated and non-isolated ARSA, respectively. DiGeorge syndrome was detected in 3% (n=2) and Turner syndrome was in 3% (n=2) of the isolated group. ARSA was not an isolated finding in any of the 4 fetuses with trisomy 18. Conclusion: Isolated ARSA may be the only antenatal predictor of trisomy 21 or other chromosomal anomalies, including DiGeorge or Turner syndrome. Hence, visualization of the right subclavian artery should be a part of the fetal anatomic survey and genetic analysis should be recommended even in the absence of associated findings., Amaç: Aberran sağ subklavyen arteri (ASSA) olan fetüslerde kromozomal anomalilerin sıklığını ve tiplerini belirlemek ve diğer sonografik bulgularla ilişkisini değerlendirmektir. Gereç ve Yöntemler: Mart 2014 ile Mart 2020 tarihleri arasında toplam 11,666 fetal anatomik inceleme yapıldı. ASSA tanısı konulan olgular incelendi. Eşlik edilen ultrason bulguları ve kromozom anormallikleri toplandı. Bulgular: Yüz kırk fetüste (%1,2) ASSA tespit edildi. ASSA, olguların %47,1’inde (66/140) izole olarak göründü ve olguların geri kalan %52,9’u (74/140) kardiyak anomaliler, ekstrakardiyak malformasyonlar veya minör belirteçler ile ilişkili bulundu. Tüm olguların %17,8’inde (25/140) kromozom anormallikleri tespit edildi. Trizomi 21, %11,4 (16/140) prevalansı ile en sık görülen kromozomal anomaliydi. İzole ve izole olmayan ASSA için karşılık gelen oranlar sırasıyla %3 (2/66) ve %18,9 (14/74) idi. İzole grupta %3 (n=2) DiGeorge sendromu ve %3 (n=2) Turner sedromu da saptandı. ASSA, trizomi 18’i olan 4 olgunun hiçbirinde izole bir bulgu değildi. Sonuç: İzole ASSA, trizomi 21’in veya DiGeorge veya Turner sendromu dahil diğer kromozomal anomalilerin tek antenatal prediktörü olabilir. Bu nedenle, sağ subklavyen arterin görselleştirilmesi fetal anatomik incelemenin bir parçası olmalı ve ilişkili bulguların yokluğunda bile genetik analiz önerilmelidir
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- 2021
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155. Association of several anomalies of supra-aortic trunks and surgically corrected aortic aneurysm
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Paula Guardia Martínez, Leydimar Anmad Shihadeh, and Patricia Barrio Martínez
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aberrant right subclavian artery ,aberrant left vertebral artery ,supra-aortic trunks anomalies ,aneurysm of ascending aorta ,aortic arch. ,Medicine ,Internal medicine ,RC31-1245 ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Published
- 2019
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156. Central arch reconstruction and thoracic endovascular aortic repair for complicated acute type B aortic dissection with aberrant right subclavian artery
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William D. Jordan, Bradley G. Leshnower, and Andy Dong
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Pulmonary and Respiratory Medicine ,Aortic dissection ,medicine.medical_specialty ,business.industry ,Aberrant right subclavian artery ,medicine.disease ,Aortic repair ,Surgery ,Acute type ,medicine ,Aorta: Surgical Technique ,Arch ,business - Published
- 2021
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157. A rare case of a blunt thoracic aortic injury in a patient with an aberrant right subclavian artery: A case report and literature review
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Brandon Diaz, Adel Elkbuli, Kyle Kinslow, Dessy Boneva, Evander Meneses, and Mark McKenney
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Aortic arch ,medicine.medical_specialty ,medicine.medical_treatment ,Population ,PTFE, polytetrafluoroethylene ,HITT, Heparin Induced Thrombocytopenia and Thrombosis ,Case Report ,TEVAR, Thoracic Endovascular Aortic Repair ,MRI, Magnetic Resonance Imaging ,NTDB-RDS, Nataional Trauma Data Bank Research Dataset ,ISS, injury severity score ,03 medical and health sciences ,0302 clinical medicine ,Blunt ,Right Common Carotid Artery ,medicine.artery ,Aberrant right subclavian artery ,medicine ,cardiovascular diseases ,education ,HIT, Heparin Induced Thrombocytopenia ,BTAI, blunt thoracic aortic injury ,CTA, Computed Tomography Angiography ,education.field_of_study ,TEVAR ,business.industry ,Stent ,Polytrauma ,CT, Computed Tomography ,medicine.disease ,Surgery ,body regions ,surgical procedures, operative ,Traumatic injury ,Blunt thoracic aortic injury ,030220 oncology & carcinogenesis ,GCS, Glasgow Coma Scale ,cardiovascular system ,MVC, motor vehicle collision ,Carotid to subclavian bypass ,030211 gastroenterology & hepatology ,Presentation (obstetrics) ,business - Abstract
Highlights • Blunt thoracic aortic injuries are life threatening and require urgent intervention. • Rare presentation of a blunt thoracic aortic injury in a patient with an aberrant right subclavian artery off the aortic arch distal to the takeoff of the left subclavian artery. • An aberrant right subclavian artery originating from the aortic arch, distal to the left subclavian artery is an anatomic variant that adds significant complexity to TEVAR., Introduction Blunt thoracic aortic injuries (BTAIs) are an uncommon traumatic injury that if not treated promptly, can result in death. We present the case of a BTAI with aberrant aortic anatomy. Presentation of case A 60-year-old female was involved in a motor vehicle crash where she suffered significant polytrauma including a BTAI. She was also found to have an aberrant right subclavian artery originating from the aortic arch. Thoracic Endovascular Aortic Repair (TEVAR) with a right common carotid artery to right subclavian artery bypass was accomplished. She required three more vascular surgical interventions, two for persistent type II endoleak and the third for left upper extremity acute limb ischemia. She had a 2-month hospital course for her devastating injuries and was eventually discharged home. A follow-up CT angiogram showed a stable thoracic aortic arch stent. Discussion BTAIs are uncommon in the trauma population. In our patient who had an aberrant right subclavian artery, further procedures were required in the form of a right common carotid artery to right subclavian artery bypass and embolizations to resolve endoleaks. Conclusion Blunt thoracic aortic injuries are life threatening and require urgent intervention. TEVAR is associated with better outcomes. An aberrant right subclavian artery originating from the aortic arch, distal to the left subclavian artery is an anatomic variant that adds significant complexity to TEVAR. TEVAR is still an option for repair of blunt thoracic aortic injuries despite anatomic variations as open repair still carries an increased risk of morbidity and mortality.
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- 2021
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158. Predictive value of aberrant right subclavian artery for fetal chromosome aneuploidy in women of advanced maternal age
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Xiao-Hong Zhong, Li-Ping Chen, Guo-Rong Lyu, Xiao-Yan Chen, Jiang-Hua Chen, Jian-Hong You, Jing-Xian Xie, Yong-Feng Lai, and Xiao-Kang Chen
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Adult ,medicine.medical_specialty ,Cardiovascular Abnormalities ,Subclavian Artery ,Reproductive medicine ,Aneuploidy ,Advanced maternal age ,lcsh:Gynecology and obstetrics ,Ultrasonography, Prenatal ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Fetus ,Pregnancy ,Risk Factors ,parasitic diseases ,Aberrant right subclavian artery ,medicine ,Humans ,030212 general & internal medicine ,lcsh:RG1-991 ,Retrospective Studies ,Ultrasonography ,Chromosome Aberrations ,030219 obstetrics & reproductive medicine ,Obstetrics ,business.industry ,Chromosomal abnormalities ,Incidence ,Incidence (epidemiology) ,Obstetrics and Gynecology ,Chromosome ,Retrospective cohort study ,Karyotype ,medicine.disease ,Karyotyping ,Pregnancy Trimester, Second ,Female ,business ,Research Article ,Maternal Age - Abstract
Background In the entire population, an aberrant right subclavian artery (ARSA) is closely associated with chromosomal abnormalities. ARSA with additional ultrasonic findings would increase risk of chromosomal abnormalities. The risk of fetal chromosomal abnormalities increased exponentially with the maternal age. These risks in the advanced maternal age (AMA) group are uncertain. This study aimed to determine the incidence of ARSA in Chinese AMA and non-AMA women and the frequency of aneuploidy among AMA and non-AMA women with ARSA. Methods This retrospective study included 13,690 singleton pregnancies, were divided into AMA and non-AMA groups. Integrated obstetric ultrasonic screening, biochemical screening, noninvasive prenatal screening, and fetal karyotype analysis were analyzed. Results The overall incidence of ARSA was 0.69%, with no difference between age groups. The incidence of chromosomal abnormalities in the AMA group (37 / 2860) was much higher than that of the non-AMA group. The risk of chromosomal abnormalities significantly increased with both ARSA detected and additional ultrasound findings. With combined ARSA and AMA, the likelihood of the incidence of chromosomal abnormalities increased. Chimerism (45X / 46XX) was found with isolated ARSA in AMA pregnancies. Conclusion There is a high prevalence of chromosomal abnormalities in fetuses of AMA women. ARSA increases the risk of chromosomal abnormalities in both age groups, especially combined with ARSA. When ARSA occurs in AMA women, it confers a high likelihood of chromosomal abnormalities.
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- 2021
159. Eighty-year-old man with 10 years dysphagia
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Showkat A. Kadla, Nisar Ahmad Shah, Shaheena Parveen, Bilal A. Khan, Asif I. Shah, Shaheen Nazir Lone, and Sandeep Sharma
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aberrant right subclavian artery ,dysphagia ,dysphagia lusoria ,vascular dysphagia ,Diseases of the digestive system. Gastroenterology ,RC799-869 - Abstract
Dysphagia is a sensation of food being "stuck" up in its passage from the mouth to stomach. It is of two main types, oropharyngeal dysphagia, and esophageal dysphagia. In oropharyngeal dysphagia, there is difficulty in transferring the food from the mouth to upper esophagus. Thus, this dysphagia is also called as transfer dysphagia. It occurs within 1 st 1-2 s of the swallow. We also call this dysphagia as instant dysphagia. It is almost always associated with sinobronchial symptoms. The second type of dysphagia is esophageal dysphagia in which there is difficulty in passing the food from upper esophagus to the stomach. The two main mechanisms responsible for dysphagia are either a problem with the motor function of oropharynx or esophagus (neuromuscular causes) or mechanical narrowing of oropharynx or esophagus (mechanical dysphagia). As this dysphagia occurs a little later in the act of swallowing, we can call it delayed dysphagia. The mechanical cause of dysphagia includes benign strictures, malignancies, webs and rings, retropharyngeal abscesses, Zenker′s diverticulum, cricopharyngeal bar, and some vascular causes. We report an 80-year-old male with vascular dysphagia.
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- 2015
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160. Selective use of superficial temporal artery cannulation in infants undergoing cardiac surgery
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Pradeep Bhaskar, Jiju John, Reyaz Ahmad Lone, and Ahmed Sallehuddin
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Aberrant right subclavian artery ,Cardiac surgery ,Invasive arterial pressure monitoring ,Superficial temporal artery cannulation ,Anesthesiology ,RD78.3-87.3 ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Arterial cannulation is routinely performed in children undergoing cardiac surgery to aid the intraoperative and intensive care management. Most commonly cannulated peripheral site in children is radial artery, and alternatives include posterior tibial, dorsalis pedis, and rarely superficial temporal artery (STA). Two specific situations in cardiac surgery where STA cannulation and monitoring was useful during the surgical procedure are reported. To our knowledge, such selective use of STA pressure monitoring has not been reported in the literature previously. Our experience suggests that STA monitoring can be useful and reliable during repair of coarctation of aorta or administration of anterograde cerebral perfusion in patients having associated aberrant origin of the right subclavian artery.
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- 2015
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161. Morphology and Outcomes of Total Endovascular Treatment of Type B Aortic Dissection with Aberrant Right Subclavian Artery.
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Zhou, Min, Bai, Xueqin, Ding, Yong, Wang, Yonggang, Lin, Changpo, Yan, Dong, Shi, Zhenyu, and Fu, Weiguo
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Objectives To characterize the morphology of type B aortic dissection with aberrant right subclavian artery (ARSA) and present early and midterm outcomes of total endovascular treatment for affected patients. Methods From January 2010 to December 2015, patients with ARSA and type B aortic dissection treated with total endovascular techniques were enrolled. The angle of the aortic arch was measured on pre-operative CTA. Sixty age and gender matched normal aortic arch patients with type B aortic dissection served as controls. Primary outcomes were technical success, 30 day mortality, and late survival. Secondary outcomes included in hospital morbidity, re-intervention rate, and patency of the subclavian artery. Results A total of 13 patients (8 men, 5 women; mean age 58 years) were included. The mean angle of the aortic arch in patients with ARSA was significantly smaller than in normal aortic arch patients (117.2° ± 10.8° vs. 124.2° ± 9.4°, respectively; p = .024). Simple thoracic endovascular aortic repair (TEVAR) and TEVAR plus a parallel graft technique were performed in six and seven patients, respectively. Primary technique success was achieved in 11 of the 13 (84.6%) patients. A bird beak configuration occurred significantly more frequently in patients with ARSA than in normal aortic arch patients (91.7% vs. 48.3%, respectively; p = .035). The median follow-up time was 36 months. One patient received a secondary procedure because of a new onset entry tear at the distal end of the stent graft. No posterior circulation stroke, permanent spinal cord ischaemia, or ischaemia of the upper arm was observed. Conclusions Type B aortic dissection with ARSA was associated with a steep aortic arch. Total endovascular treatment for these patients was feasible and safe. Stent grafts with better flexibility and appropriate extension of the proximal landing zone with a parallel graft technique are suggested based on the observed outcomes. [ABSTRACT FROM AUTHOR]
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- 2017
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162. 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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Shindo, Koji, Nagai, Eishi, Nabae, Toshinaga, Eguchi, Toru, Moriyama, Taiki, Ohuchida, Kenoki, Manabe, Tatsuya, Ohtsuka, Takao, Oda, Yoshinao, Hashizume, Makoto, and Nakamura, Masafumi
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CHEST endoscopic surgery ,ESOPHAGEAL cancer patients ,SUBCLAVIAN artery ,LARYNGEAL nerves - 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. [ABSTRACT FROM AUTHOR]
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- 2017
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163. A Bump in the Road: An Uncommon Cause of Dysphagia.
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Boomgaert, Lukas and Balliauw, Christophe
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- 2017
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164. 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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Hussain Naqvi, Sayyed Ehtesham, Beg, Mohammed Hanif, Singh Thingam, Shyam Kumar, and Ali, Eram
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ESOPHAGEAL tumors , *COUGH , *TRACHEAL fistula , *JEJUNOSTOMY , *SEPSIS , *SUBCLAVIAN artery , *DIAGNOSIS - 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. [ABSTRACT FROM AUTHOR]
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- 2017
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165. The aberrant right subclavian artery: cadaveric study and literature review.
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Natsis, Konstantinos, Didagelos, Matthaios, Gkiouliava, Anna, Lazaridis, Nikolaos, Vyzas, Vasilios, and Piagkou, Maria
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THORACIC aorta , *SUBCLAVIAN artery , *DEGLUTITION disorders , *BIOLOGICAL variation , *MEDICAL cadavers - Abstract
Purpose: Taking into consideration that the aberrant right subclavian artery (ARSA) is the commonest congenital aortic arch anomaly (prevalence 0.16-4.4%), our goal was to investigate its incidence in Greeks, with respect to location, course, and relationship to trachea and esophagus. Gender dimorphism, coexisting neural, and vascular variations were also examined. The clinical impact and embryological background of the variation are discussed. Methods: Two hundred and sixty-seven (126 male and 141 female) formalin-embalmed Greek cadavers (mean age 59 ± 13 years) were examined. Results: The ARSA was detected in 6 cadavers (2.2%), 4 females (2.8%) and 2 males (1.6%). The artery followed a retroesophageal course in 83%, an interesophageotracheal course in 16.7%, while no pretracheal ARSA was detected. The ARSA coexisted with a bicarotid trunk, a Kommerell diverticulum, and a combination of them in one cadaver. Α combination of the ARSA with a thyroidea ima artery and a bilateral abnormal origin of the internal mammary artery was also detected in one case (17%), while no other associated anomaly was detected in a single case (17%). All ARSAs were accompanied with a right non-recurrent laryngeal nerve. Conclusion: The ARSA has a relative high incidence in Greeks and a female predominance. The aberrant vessel follows a retroesophageal course in most cases and only one case with a location between trachea and esophagus was detected. The retroesophageal ARSA justifies the wide variety of clinical manifestations and complications occurred. [ABSTRACT FROM AUTHOR]
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- 2017
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166. Incidence of an Aberrant Right Subclavian Artery on Second-Trimester Sonography in an Unselected Population.
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Gursoy Erzincan, Selen, Karamustafaoglu Balci, Burcin, Tokgoz, Cengiz, and Kalelioglu, Ibrahim Halil
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Objectives: The aim of this study was to assess the incidence of an aberrant right subclavian artery (ARSA) among an unselected population during second ‐ trimester sonography and to review the importance of this conotruncal variant as a marker of Down syndrome. Methods: The presence or absence of an ARSA was assessed in an unselected population of 1913 second ‐ trimester fetuses. Results: Among the 1913 patients, an ARSA was detected in 20 fetuses (1.04%), all with a normal karyotype. Thirteen of 20 fetuses had an isolated ARSA, and 7 of them were nonisolated. Associated abnormal sonographic findings were an intracardiac echogenic focus (n = 3), a choroid plexus cyst (n = 1), pyelectasis (n = 1) and tetralogy of Fallot (n = 2). One of the cases of tetralogy of Fallot was also associated with a persistent left superior vena cava, a persistent right umbilical vein, hydrocephalus, rhombencephalosynapsis, and unilateral renal agenesis. There were only 2 fetuses with Down syndrome in this group, and both of them had a normal origin of the right subclavian artery. Conclusions: In an unselected population, an ARSA may be seen less frequently than in a high ‐ risk population and may not be related to Down syndrome. An isolated ARSA is not a sufficient indication for karyotype analysis; it can be managed with noninvasive prenatal testing rather than invasive testing. [ABSTRACT FROM AUTHOR]
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- 2017
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167. Aberrant Right Subclavian Artery: Correlation Between Fetal and Neonatal Abnormalities and Abnormal Genetic Screening or Testing.
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Ranzini, Angela C., Hyman, Francine, Jamaer, Emily, and van Mieghem, Tim
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Objectives: To determine whether fetuses with an isolated aberrant course of the right subclavian artery (ARSA) have increased risk for chromosomal abnormalities, including trisomy 21 or 22q11 deletion. Methods: We performed a retrospective chart review of all fetuses with antenatally diagnosed ARSA. Data were collected from fetal anatomic surveys, fetal echocardiograms, noninvasive trisomy 21 screening programs, invasive genetic studies, and neonatal records. Results: Seventy ‐ nine fetuses with ARSA were identified at 20.3 ± 3.8 weeks' gestation. Forty ‐ eight fetuses underwent chromosomal evaluation. Of those, seven had trisomy 21. Four other fetuses had unusual karyotype abnormalities. All fetuses with genetic anomalies had additional aberrant ultrasound findings. There were three spontaneous fetal deaths (trisomy 21 ‐ 2 and Wolf ‐ Hirshhorn ‐ 1). Nine pregnancies were terminated because of abnormalities and one died as a result of hypoplastic left heart syndrome. No neonate was found or suspected to have 22q11.2 deletion. The ARSA was isolated in 43 fetuses; all had unremarkable neonatal outcomes, and none were readmitted within 6 months after discharge. Conclusions: As an apparently isolated finding, ARSA is benign and not associated with trisomy 21 or 22q11.2 deletion. The finding of ARSA, however, warrants a detailed fetal ultrasound. All fetuses with ARSA and genetic anomalies had additional ultrasound findings. [ABSTRACT FROM AUTHOR]
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- 2017
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168. Fenestrated Physician-Modified Endovascular Grafts for Aberrant Right Subclavian Artery and/or Kommerell's diverticulum.
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Bacri C, Chastant R, Chassin-Trubert L, Hireche Md K, Alric P, and Canaud L
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Objective: The aim of this case series is to report feasibility, efficiency, and safety of fenestrated physician-modified endografts (PMEGs) in aortic arch pathologies with aberrant right subclavian artery (ARSA) and/or Kommerell's diverticulum (KD)., Methods: All consecutive patients with ARSA and/or KD who underwent hybrid aortic arch repair combined with homemade fenestrated stent-graft from 2018 to 2022 were reviewed., Results: Six patients with ARSA and/or KD underwent hybrid surgery for aortic repair, 4 of whom were men, with a mean age of 49 years. Furthermore, 2 of them were symptomatic with dysphagia, 1 was taken in emergency, 1 had a bovine arch and a KD, and 2 had right descending thoracic aortas. The mean operation time was 138 (111-216) minutes. In addition, 83% of the homemade grafts were double fenestrated. All the proximal landings were in zone 0; the mean proximal aortic diameter was 29 (23-34) mm. The range of diameters for the endografts were 24 to 38 mm. There was a 100% technical success, with 0% 30 days mortality, no stroke, and no endoleak. During the follow-up, no aortic-related death or secondary intervention was required and all supra-aortic vessels remain patent., Conclusion: Hybrid aortic arch repair, with fenestrated PMEGs for ARSA and/or KD, is associated with acceptable early and midterm major morbidity and mortality., Clinical Impact: This retrospective case series analyzed outcomes in 6 patients with an aberrant right subclavian artery and/or Kommerell's diverticulum treated with fenestrated PMEGs during an average 16 month follow-up. The case series suggests that the use of these fenestrated PMEGs for the management of patients with an aberrant right subclavian artery is a safe, effective and durable method in the medium-term.
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- 2023
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169. Aberrant right subclavian artery: a novel approach and an overview of operative techniques.
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Heye T, Greiten L, Story-Hefta L, Reemtsen B, and Moursi M
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An aberrant right subclavian artery (ARSA) is a rare variation of normal anatomy occurring in 0.5% to 1.8% of the population. No current guidelines are available regarding ARSA management, and surgical intervention should be evaluated carefully. Moreover, symptomatic patients with a dominant left arch and aberrant ARSA require a surgical approach from the right side of the chest for ligation and division of the aberrant artery at its origin on the aorta. The ARSA can then be reimplanted onto the right common carotid artery via a supraclavicular incision. The extensive mobilization in the chest allows for easy reimplantation in the supraclavicular region and eliminates reliance on the collateral circulation. Postoperative monitoring is reliable and easy with radial pulse examinations., Competing Interests: None.
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- 2023
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170. Hybrid repair of aberrant right subclavian artery using open and endovascular techniques.
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Nguyen D, Leon LR, and Berman SS
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An aberrant right subclavian artery, the most common anatomic variant of the aortic arch, occurs in 0.5% of the population. Symptoms generally result from compression of the esophagus and/or trachea as the aberrant vessel passes posteriorly in the mediastinum. Treatment includes revascularization of the right subclavian artery from the right common carotid artery using a cervical approach combined with occlusion of the origin of the aberrant vessel from the thoracic aorta. We describe a hybrid treatment approach for a symptomatic aberrant right subclavian artery using cervical revascularization and branched thoracic stent graft coverage of the origin of the aberrant vessel., Competing Interests: None., (© 2023 The Author(s).)
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- 2023
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171. Surgical repair of severe dysphagia lusoria.
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Michos L, Hart C, Nantermet S, and Meisner R
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This case report describes a case of severe dysphagia lusoria secondary to an aberrant right subclavian artery causing compression of the esophagus. Our 62-year-old female patient presented with severe dysphagia and underwent right carotid-subclavian bypass with uncovered thoracic endovascular aortic repair and coil embolization of the aberrant right subclavian artery. This case is unique in that an uncovered dissection stent graft was used to avoid occluding the anatomic left subclavian artery and, therefore, avoid a left carotid-subclavian bypass. This case highlights a unique anatomic variant, its surgical repair, and the long-term improvement in the patient's quality of life., (© 2023 Published by Elsevier Inc. on behalf of Society for Vascular Surgery.)
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- 2023
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172. Aberrant Right Subclavian Artery Identified before Carotid Artery Stenting.
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Tanaka T, Sashida R, Hirokawa Y, and Matsuno A
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Competing Interests: None
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- 2023
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173. Primary percutaneous coronary intervention in a patient with right internal mammary artery graft originating from arteria lusoria dextra
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Aleksandrić Srđan, Stojković Siniša, Tomašević Miloje, Kostić Jelena, Banović Marko, Menković Nemanja, and Ostojić Miodrag
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arteria lusoria dextra ,aberrant right subclavian artery ,ST elevation myocardial infarction ,percutaneous coronary intervention ,congenital aortic arch anomalies ,radial approach ,Medicine - Abstract
Introduction. Congenital anomalies of the aortic arch, although numerous and heterogeneous, occur in less than 1% of individuals at autopsies. Left aortic arch with an aberrant right subclavian artery, also called arteria lusoria dextra, is the most common anomaly of the aortic arch, occurring in 0.5-2.5% of individuals. Case Outline. We report the case of a 48-year-old man suffering from acute inferoposterior-wall ST elevation myocardial infarction successfully treated by primary percutaneous coronary intervention. Ten years ago, the patient had undergone coronary artery bypass graft surgery with the implantation of two arterial grafts - left and right internal mammary arteries on both left anterior descending and right coronary artery. After several attempts to canulate truncus brachiocephalicus, angiogram revealed the left aortic arch with the aberrant right subclavian artery. To our knowledge, this is the first described case of primary percutaneous coronary intervention via the aberrant right subclavian artery and right internal mammary artery graft with stent implantation in the infarct related lesion of the distal segment of right coronary artery. Subsequent 64-multidetector computed tomography confirmed the angiographic findings. Conclusion. Early recognition of congenital anomalies of the aortic arch and its great vessels, even before coronary artery bypass graft surgery, could be crucial for the urgent and successful treatment of patients with life-threatening conditions, such as ST segment elevation myocardial infarction.
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- 2013
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174. A Patient with Dysphagia.
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Mazokopakis, Elias E., Tsekouras, Konstantinos C., and Giannakopoulos, Triantafillos G.
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We report a case of an uncommon type of dysphagia, due to esophagus compression by an aberrant right subclavian artery. This condition, known as dysphagia lusoria, was first recorded in 1787 by London physician David Bayford. [ABSTRACT FROM AUTHOR]
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- 2019
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175. An unusual Cause of Late-Onset Dysphagia: Aberrant Right Subclavian Artery.
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Aslan, Serdar and Elmalı, Muzaffer
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- *
SUBCLAVIAN artery , *DEGLUTITION disorders , *ESOPHAGEAL motility disorders , *BRANCHIAL arch , *EMBRYOLOGY , *ESOPHAGEAL motility - 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. [ABSTRACT FROM AUTHOR]
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- 2019
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176. Persistan Siyatik Arter: İnternal İliak Arterden Köken Alan Derin Femoral Arter.
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YETÜT, Doğan, ÖZTAŞ, Didem Melis, UĞURLUCAN, Murat, BOZBUĞA, Nilgün, and ALPAGUT, Ufuk
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- *
ILIAC artery , *SUBCLAVIAN artery , *FEMORAL artery , *PERIPHERAL vascular diseases , *ARTERIES - Abstract
The persistent sciatic artery is the continuation of the axial artery in fetal life and connects internal iliac arteries to popliteotibial vessels. It is a rare arterial variation. Although persistent sciatic artery is rare, atherosclerotic stenosis or aneurysm can be seen. If aneurysm is detected, treatment with interventional or surgical methods should be considered in order to prevent the risk of embolization or rupture. In this case report, we present a 33-year-old female patient with severe ischemic lesions on her feet who had femoral artery originated from internal iliac artery together with aberrant right subclavian artery and our treatment strategy. [ABSTRACT FROM AUTHOR]
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- 2019
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177. Axillary Lymph Node Metastasis in Gallbladder Carcinoma with Incidentally Detected Coexistence of Aberrant Right Subclavian Artery with Left-Sided Superior Vena Cava.
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Das, Jayanta, Ray, Soumendranath, Rahman, Mohammad Saifur, and Ghosh, Joydeep
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- *
VENA cava superior , *SUBCLAVIAN artery , *GALLBLADDER , *GALLBLADDER cancer , *LYMPH nodes , *POSITRON emission tomography , *CARCINOMA - Abstract
The sequential development of port site recurrence, followed by recurrence in the axillary lymph node in gallbladder carcinoma is very infrequently reported in the literature. The representing 18F-fluorodeoxyglucose positron emission tomography-computed tomography image shows a metastatic right axillary lymph node in a case of gallbladder cancer developed following surgical removal of port site recurrence and six cycles of chemotherapy. The image also shows coexistence of two incidentally detected vascular anomalies, i.e., aberrant right subclavian artery and left-sided superior vena cava. Coexistence of both the vascular anomalies is rare among the general population and have their own clinical implications as described. [ABSTRACT FROM AUTHOR]
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- 2019
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178. Simple Endovascular Repair for Symptomatic Aberrant Right Subclavian Artery in a Debilitated Patient.
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Kowatari, Ryosuke, Suzuki, Yasuyuki, Daitoku, Kazuyuki, Taniguchi, Satoshi, Kakehata, Shinya, and Fukuda, Ikuo
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- *
DIAGNOSIS of dyspnea , *BLOOD-vessel abnormalities , *ENDOVASCULAR surgery , *CEREBRAL anoxia , *COMPUTED tomography , *SUBCLAVIAN artery , *SURGICAL complications , *TRACHEAL diseases , *TRACHEOTOMY , *THERAPEUTIC embolization , *STENOSIS , *TREATMENT effectiveness , *DISEASE complications , *THERAPEUTICS ,SUBCLAVIAN artery surgery ,CAROTID artery abnormalities - Abstract
We report a simple endovascular repair for symptomatic aberrant right subclavian artery (ARSA) in an 11-year-old girl. She had undergone tracheostomy due to hypoxic encephalopathy after cardiac surgery and suffered from dyspnea. Computed tomography revealed tracheal stenosis caused by a vascular ring made with an ARSA and the right common carotid artery. Transcatheter ARSA embolization using an Amplatzer vascular plug and coils was performed. Symptoms improved within a few days after this intervention and no complications such as upper extremity ischemia were encountered. Computed tomography showed the ARSA around the trachea had reduced in size and tracheal stenosis was improved. [ABSTRACT FROM AUTHOR]
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- 2019
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179. Pleural Approach to Aberrant Right Subclavian Artery in Aortic Surgery
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Ken-ichi Imasaka, Kazuhiro Kurisu, Yasutaka Ueno, Akira Hashino, and Akira Shiose
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Aortic arch ,medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,thoracic aortic aneurysm ,Aberrant right subclavian artery ,Case Report ,General Medicine ,medicine.disease ,Thoracic aortic aneurysm ,aberrant right subclavian artery ,Surgery ,median sternotomy ,medicine.anatomical_structure ,Axillary artery ,Median sternotomy ,medicine.artery ,Occlusion ,cardiovascular system ,medicine ,cardiovascular diseases ,Esophagus ,business ,Artery - Abstract
An aberrant right subclavian artery usually arises from the aortic arch just distal to the left subclavian artery and crosses behind the esophagus on its way to the right axillary artery. Several reconstructive techniques of this artery in aortic surgery have been reported but mostly resulted in troublesome procedures. Here, we describe an alternative strategy presenting the occlusion of the aberrant right subclavian artery through the right pleural approach followed via extraanatomical axillary artery bypass. This surgical approach might be a simple and safe option for the aberrant right subclavian artery.
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- 2021
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180. A rare case of obstructive supracardiac TAPVR (Total Anomalous Pulmonary Venous Return) with aberrant right subclavian artery
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Basharat Hussain, Sabiha Khan, Waqas Ali, Karachi. Nicvd, Asif Ali Khuhro, Shakeel Ahmed, and Fazal ur Rehman
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medicine.medical_specialty ,business.industry ,Internal medicine ,Rare case ,cardiovascular system ,medicine ,Cardiology ,Aberrant right subclavian artery ,business ,Total anomalous pulmonary venous return - Abstract
Congenital aortic arch malformations manifest a broad-spectrum of differences and abnormalities that come from disturbed embryogenesis of branchial arches. Current case was a 10 months old baby girl with length of 69 cm (less than –3 SD) and weight of 5.5 kg (less than –3 SD). The patient had history of recurrent lower respiratory tract infections since the time of birth and failure to gain adequate weight since the time of birth. The patient has been having multiple check-ups with registered medical practitioners in the nearby locality and multiple courses of antibiotics with only partial resolution of symptoms. The 2-D echocardiogram showed her to be a case of supracardiac type of “Total Anomalous Pulmonary Venous Return (TAPVR)”. All pulmonary veins making a confluence and draining into the right atrium. Significant turbulence observed at the level of superior vena cava to right atrium junction. A level of obstruction was recorded at the junction of the confluence of pulmonary veins and the vertical vein. There was aberrant right subclavian artery from the aortic arch as its third branch with no obstruction or aneurysm formation, having retrotracheal and esophageal course.
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- 2021
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181. Is it useful to evaluate the presence of aberrant right subclavian artery in prenatal diagnosis ultrasounds?
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Miguel Ruiz de Azúa, Ana Usano, Tirso Pérez-Medina, Cristina Martínez-Payo, Ana Siles, Yolanda Nieto-Jiménez, and Elena Suanzes
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medicine.medical_specialty ,Cardiovascular Abnormalities ,Population ,Subclavian Artery ,Aneuploidy ,Prenatal diagnosis ,Ventriculoseptal defect ,Ultrasonography, Prenatal ,03 medical and health sciences ,0302 clinical medicine ,Pregnancy ,Second trimester ,Prenatal Diagnosis ,medicine ,Humans ,education ,education.field_of_study ,030219 obstetrics & reproductive medicine ,business.industry ,Obstetrics and Gynecology ,Aberrant right subclavian artery ,medicine.disease ,Aneurysm ,Cross-Sectional Studies ,030220 oncology & carcinogenesis ,cardiovascular system ,Female ,Radiology ,business ,Trisomy - Abstract
Aim Analyze if the evaluation of aberrant right subclavian artery in the prenatal echography has improved the detection of chromosomal, genetic and/or morphological abnormalities in our population. Methods Descriptive, observational, cross-sectional study of the cases of aberrant right subclavian artery diagnosed in our Prenatal Diagnosis Unit between January of 2011 and December of 2018. Results Two hundred and fifty-seven cases of aberrant right subclavian artery were diagnosed and among them, 179 were considered isolated cases and thus were confirmed after birth. The detection of aberrant right subclavian artery did not improve itself neither the diagnosis of trisomy 21 in the second trimester of pregnancy nor other chromosomal or genetic abnormalities, including the not isolated cases. There were two cases of trisomy 21 diagnosed in the second trimester that presented major sonographic disorders and an inadequate examination during the first trimester. When aberrant right subclavian artery was associated with soft markers of aneuploidy in the second trimester, any case was a trisomy 21. Aberrant right subclavian artery seems to be associated with some minor and major heart defects, especially ventriculoseptal defect and aneurismatic ductus, and in some cases, also with clubfeet. Conclusion When an adequate screening of aneuploidies and a thorough ultrasound have been performed during the first trimester, aberrant right subclavian artery hardly helps to perform other diagnosis in the second trimester.
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- 2020
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182. A case of esophageal cancer with an aberrant right subclavian artery treated with mediastinoscopic esophagectomy
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Kazufumi Sakurama, Kazuhiro Noma, Yasuhiro Shirakawa, Masashi Hashimoto, Shunsuke Tanabe, Naoaki Maeda, and Toshiyoshi Fujiwara
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medicine.medical_specialty ,Past medical history ,business.industry ,medicine.medical_treatment ,Aberrant right subclavian artery ,General Medicine ,Esophageal cancer ,medicine.disease ,Surgery ,03 medical and health sciences ,Prone position ,Dissection ,0302 clinical medicine ,medicine.anatomical_structure ,Esophagectomy ,030220 oncology & carcinogenesis ,medicine ,030211 gastroenterology & hepatology ,Risk factor ,business ,Lymph node - Abstract
An aberrant right subclavian artery (ARSA) is one of the famous anatomical abnormalities with a prevalence of 0.16-4.4%. In esophagectomy, anatomical abnormalities of the ARSA could cause complications with some surgical procedures. An 85-year old man was referred to our department for esophageal adenocarcinoma that was at a slightly high position for esophagectomy with the abdominal approach. However, he had a significant past medical history. This risk factor made it difficult to perform thoracoscopic esophagectomy. He underwent mediastinoscopic esophagectomy (ME) with the left cervical and laparoscopic approach. The ARSA presented no difficulties with the ME surgical technique including the dissection of the left recurrent laryngeal nerve lymph node. Although this patient had a respiratory dysfunction and some difficulties in a prone position, ME enabled a safe esophagectomy with lymph node dissection.
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- 2020
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183. Hybrid Endovascular Treatment of Dysphagia Lusoria: Report of 2 Cases
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Erik J. Wayne, Amit J. Dwivedi, and Abindra Sigdel
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medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,Dysphagia lusoria ,Aberrant right subclavian artery ,General Medicine ,030204 cardiovascular system & hematology ,medicine.disease ,Surgery ,03 medical and health sciences ,0302 clinical medicine ,Symptom relief ,cardiovascular system ,Medicine ,030211 gastroenterology & hepatology ,cardiovascular diseases ,Thoracotomy ,Embolization ,Endovascular treatment ,Cardiology and Cardiovascular Medicine ,business ,Complication - Abstract
Dysphagia Lusoria is a condition when aberrant right subclavian artery (ARSA) causes esophageal compression. We report 2 cases of Dysphagia Lusoria treated by hybrid endovascular technique which included subclavian to carotid transposition and embolization of origin of ARSA. By using this technique, we avoided the need for thoracotomy. Both patients had complete symptom relief without any surgery related complication.
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- 2020
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184. An Unrecognized Contraindication to Transesophageal Echocardiographic Probe Placement: The Aberrant Right Subclavian Artery
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Mark J.S. Heath, Hiroo Takayama, Jessica Spellman, and David A. Apatov
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medicine.medical_specialty ,business.industry ,Aberrant right subclavian artery ,Vascular anomaly ,General Medicine ,THORACIC OUTLET OBSTRUCTION ,medicine.disease ,Arterioesophageal fistula ,medicine ,Radiology ,business ,Surgical Situations ,Transesophageal echocardiography ,Contraindication ,Thoracic outlet obstruction ,ComputingMethodologies_COMPUTERGRAPHICS - Abstract
Graphical abstract, Highlights • A TEE probe can compress an ARSA. • ARSA compression can be unsafe. • The authors offer guidelines for safe use of TEE probes.
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- 2020
185. Dysphagia of aberrant right subclavian artery treated by endoscopic dilation: An alternative to surgical treatment in select cases—A case report
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Troy A. Moritz and Homa Sadeghian
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medicine.medical_specialty ,Computed tomography ,Article ,03 medical and health sciences ,0302 clinical medicine ,Case report ,medicine ,In patient ,Surgical treatment ,Endoscopic dilation ,medicine.diagnostic_test ,Esophagogastroduodenoscopy ,business.industry ,Aberrant subclavian artery ,Aberrant right subclavian artery ,Endoscopy ,Dysphagia ,medicine.disease ,Surgery ,Treatment ,Dilation ,030220 oncology & carcinogenesis ,Esophageal stricture ,030211 gastroenterology & hepatology ,medicine.symptom ,business - Abstract
Highlights • Aberrant right subclavian artery (ARSA) is a rare cause of dysphagia. • Surgical intervention is the mainstem of therapy. • Endoscopic dilation is a suitable treatment alternative in non-surgical candidates., Introduction The aberrant right subclavian artery (ARSA) is a rare cause of dysphagia. Surgical intervention has remained the mainstem of therapy, accompanied with certain morbidities and mortalities. Although rarely reported in literature, endoscopic dilation may be considered a suitable treatment alternative in patients who are not a surgical candidate or do not consent for surgery. We report a case suffering from dysphagia and diagnosed with ARSA treated by endoscopic dilation. Presentation of case A 52-year-old male presented to our clinic in 2015 with dysphagia. Chest Computed Tomography scan confirmed the diagnosis of ARSA. He first underwent esophagogastroduodenoscopy (EGD) with staged dilation of the stricture, making him free of his symptoms for an approximate 2.5 years. Upon recurrence of symptoms in 2018, he underwent repeat endoscopic dilation, which again completely resolved the symptom with an excellent peri-operative and post-operative course. Conclusion Endoscopic dilation of the esophageal stricture in patients with ARSA is a safe alternative to surgery in patients who are unable or unwilling to undergo surgery. It provides relief for a relatively long time and can be safely repeated multiple times upon recurrence.
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- 2020
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186. A case of brain and spinal cord infarction caused by artery-to-artery embolism from the aberrant right subclavian artery stenosis
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Yuri Sugiura, Tomoya Chiba, Masayuki Moriya, Takashi Miwa, Hisashi Murata, Chikao Tatsumi, Tomohiro Yata, and Katsuya Araki
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medicine.medical_specialty ,business.industry ,Brain infarction ,Internal medicine ,Cardiology ,medicine ,Aberrant right subclavian artery ,Spinal cord infarction ,business - Published
- 2020
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187. Aberrant right subclavian artery with atrial septal defect: Simultaneous repair via median sternotomy
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Hina Inam, Waris Ahmad, Abdul Ahad Sohail, and Narmeen Asif
- Subjects
Aortic arch ,medicine.medical_specialty ,medicine.medical_treatment ,Retroesophageal ,Article ,03 medical and health sciences ,0302 clinical medicine ,medicine.artery ,Aberrant right subclavian artery ,medicine ,otorhinolaryngologic diseases ,cardiovascular diseases ,Arteria lusoria ,Esophagus ,business.industry ,Dysphagia ,eye diseases ,Surgery ,medicine.anatomical_structure ,Median sternotomy ,030220 oncology & carcinogenesis ,cardiovascular system ,030211 gastroenterology & hepatology ,medicine.symptom ,Presentation (obstetrics) ,business - Abstract
Highlights • 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., Introduction 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. Presentation of case 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. Discussion 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. Conclusion 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.
- Published
- 2020
188. 2000 Hastada Konjenital Mediastinial Vasküler Anomoli Tiplerinin ve Sıklığının Değerlendirilmesi
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DADALI, Yeliz, ÖZKAÇMAZ, Sercan, DEMİR, Mustafa, BURSALI, İlke, and ALKÜ
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General and Internal Medicine ,Computed Tomography ,Bilgisayarlı Tomografi,Bilgisayarlı Tomografi,Parsiyel anormal pulmoner venöz dönüş anomalisi,Sağ aberran subklavien arter,Situs inversus totalis,Genişlemiş sol superior interkostal ven ,Dilated left superior intercostal vein ,Aberrant right subclavian artery ,Computed Tomography,Computed Tomography,Partial anomalous pulmonary venous return,Aberrant right subclavian artery,Situs inversus totalis,Dilated left superior intercostal vein ,Situs inversus totalis ,Partial anomalous pulmonary venous return ,Genel ve Dahili Tıp - Abstract
Aim: Congenital vascular malformations of the thorax are not very common. These conditions are mostly asymptomatic and detected incidentally on imaging performed for various complaints. In this study, it is aimed to examine the incidence of congenital thoracic vascular anomalies in our region.Methods: The features of the patients with non-specific complaints who underwent a thorax Computed Tomography (CT) for over 2 years period were retrospectively reviewed on the hospital database and demographical data (Gender and age) were recorded. All the Computed Tomography CT images were interpreted regarding thoracic vascular anomalies including persistent left superior vena cava, azygos lobe, aberrant right subclavian artery, dilated left superior intercostal vein, right-sided aortic arch, situs inversus, and partial anomalous pulmonary venous return. The incidences of these thoracic vascular anomalies were calculated and compared with previous studies. Results: A total of 2000 patients with a mean age of 56.13±14.62 (12-93 years) were included in this study. Among them 776 (38.8%) ones were female (mean age 56.93±15.19 (13-93 years)) and 1224 (61.2%) were male (mean age 55.63±14.23 (12-88 years)). Mediastinal vascular anomaly was detected in 62 (3.1%) patients. A mediastinal vascular anomaly was observed in 27 (3.5%) female patients and 35 (2.6%) male patients. The most common mediastinal vascular anomaly inthis study was the right aberrant subclavian artery (n:17, 0.9%) and the rarest was partial anomalous pulmonary venous return (n:1, 0.1%). Persistent left superior vena cava incidence was 0.3% (n:6), azygos lobe 0.7% (n:14), right-sided aortic arch 0.3% (n:5), situs inversus totalis 0.2% (n:3), and dilated left superior intercostal vein 0.8% (n:16).Conclusion: Mediastinal vascular anomalies are rare and usually asymptomatic. But the imaging findings of these conditions must be well-known to accurately planning the interventions and also to prevent iatrogenic injuries., Amaç: Toraksın konjenital vasküler anomalileri çok sık olmayıp sıklıkla asemptomatiktirler ve görüntülemelerde tesadüfen saptanırlar. Bu çalışmamızda bölgemizde konjenital mediastinal vasküler anomalilerin sıklığını araştırmayı planladık.Yöntem: Yaklaşık 2 yıllık bir süreçte non-spesifik semptomlar ile kontrastlı toraks Bilgisayarlı Tomografi (BT) çekilen hastaların özellikleri hastane veri tabanından retrospektif olarak tarandı. Yaş ve cinsiyet gibi demografik özellikler kaydedildi. Tüm Bilgisayarlı Tomografi (BT) BT görüntüleri, persistan sol superior vena kava, azygos lobu, aberran sağ subklavien arter, dilate sol superior interkostal ven, sağ taraflı arkus aorta, situs inversus ve parsiyel anormal pulmoner venöz dönüş anomalileri açısından yorumlandı. Çalışmamızda bulunan insidans değerleri ile önceki çalışmaların sonuçları karşılaştırıldı. Bulgular: Nihai olarak ortalama yaşı 56.13±14.62 (12-93 yıl) olan 2000 hasta çalışmaya dahil edildi. Bunların 776 (%38.8) tanesi kadın (ortalama yaş 56.93±15.19 (13-93 yıl)) ve 1224 (% 61.2) tanesi erkekti (ortalama yaş 55.63±14.23 (12-88 yıl)). Mediastinal vasküler anomali 62 (%3.1) hastada saptandı. Kadın hastaların 27 (%3.5)’inde ve erkek hastaların 35 (%2.6) ’inde bir mediastinal vasküler anomali gözlemlendi. Çalışmamızdaki en sık saptanan mediastinal vasküler anomali, sağ aberran subklavien arter (n:17, %0.9) ve en nadir görüleni ise parsiyel anormal pulmoner venöz dönüş anomalisi idi (n:1, %0.1). Persistan sol superior vena kava insidansı %0.3 (n:6), azygos lobu %0.7 (n:14), sağ taraflı arkus aorta %0.3 (n:5), situs inversus totalis %0.2 (n:3) ve genişlemiş sol superior interkostal ven ise %0.8 (n:16) olarak bulundu.Sonuç: Mediastinal vasküler anomaliler nadir olup sıklıkla asemptomatiktir. Ancak bu durumların görüntüleme bulgularının iyi bilinmesi, girişimsel işlemleri doğu biçimde planlamada ve aynı zamanda iatrojenik yaralanmaları önlemede gereklidir.
- Published
- 2022
189. Aberrant Right Subclavian Artery: Multiple Solutions for a Complex Anomaly of the Aortic Arch
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Antonio Bozzani, Franco Ragni, and Antonio V. Sterpetti
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Pulmonary and Respiratory Medicine ,Aortic arch ,business.industry ,medicine.artery ,Aberrant right subclavian artery ,Medicine ,Surgery ,Anatomy ,Anomaly (physics) ,Cardiology and Cardiovascular Medicine ,business - Published
- 2022
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190. Dysphagia Lusoria with atrial septal defect: Simultaneous repair through midline
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Rithin Rathnakar, Saket Agarwal, Vishnu Datt, and Deepak K Satsangi
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Aberrant right subclavian artery ,dysphagia lusoria ,vascular ring ,Medicine ,Pediatrics ,RJ1-570 ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
An aberrant right subclavian artery from the descending aorta is almost always reported as an isolated anomaly. We present the case of a four-year-old child with an anomalous origin of the right subclavian artery from the descending aorta, associated with an ostium secundum atrial septal defect. The patient underwent simultaneous repair of both the anomalies through median sternotomy, with implantation of the subclavian artery into the right common carotid artery. We believe that median sternotomy is the optimal surgical approach for the management of these lesions. Other operative approaches are also discussed.
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- 2014
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191. Dysphagia lusoria: uncommon cause of dysphagia in children
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Helena Moreira-Silva, Gisela Silva, and Rosa Lima
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Aberrant right subclavian artery ,Dysphagia lusoria ,Esophageal compression ,Diseases of the digestive system. Gastroenterology ,RC799-869 - Published
- 2018
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192. An Elegant Solution to a Ruptured Right Aberrant Subclavian Artery after Oesophageal Stent Removal
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Hansraj Bookun, Sophie Cerutti, Daniel B. Thompson, Yahya Lahham, Muhammad Peerbux, and Anna Ikponmwosa
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medicine.medical_specialty ,Surgical approach ,business.industry ,Fistula ,medicine.medical_treatment ,General Engineering ,Stent ,Aberrant right subclavian artery ,Case Report ,Endotracheal intubation ,030204 cardiovascular system & hematology ,medicine.disease ,Surgery ,Aberrant subclavian artery ,03 medical and health sciences ,surgical procedures, operative ,0302 clinical medicine ,Oesophageal stent ,RC666-701 ,030220 oncology & carcinogenesis ,Diseases of the circulatory (Cardiovascular) system ,Medicine ,cardiovascular diseases ,Complication ,business - Abstract
Arterioenteric or arteriotracheal fistula is a known complication of an aberrant right subclavian artery (ARSA) and is often associated with prolonged nasogastric or endotracheal intubation or oesophageal stenting. Fistula formation from the ARSA can present unexpectedly with rapid exsanguination with massive haemoptysis or haematemesis, and unless promptly recognised and treated is rapidly fatal. We present a novel endovascular method for treating a fistula between the oesophagus, trachea and an ARSA in an unstable patient following oesophageal stent removal, utilising a covered iliac limb stent, eliminating the need for an open surgical approach.
- Published
- 2021
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193. Hybrid repair of aberrant right subclavian artery with aortic dissection caused by Kommerell diverticulum
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Yuanfeng Xin, Guoliang Fan, Lin Zou, Tieyan Li, and Yunzhen Feng
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Aortic dissection ,Aortic arch ,Kommerell diverticulum ,medicine.medical_specialty ,Hybrid repair ,business.industry ,Aberrant right subclavian artery ,Case Report ,Dissection (medical) ,medicine.disease ,Cardiac surgery ,Surgery ,surgical procedures, operative ,Aneurysm ,RC666-701 ,medicine.artery ,cardiovascular system ,medicine ,Diseases of the circulatory (Cardiovascular) system ,cardiovascular diseases ,Cardiology and Cardiovascular Medicine ,business ,Angiology - Abstract
Background Aberrant right subclavian artery (ARSA) with associated Kommerell diverticulum (KD) is a rare congenital aortic disease. KD patients have a high risk of rupture, dissection, and compression of adjacent structures. Although several treatment options have been proposed (traditional surgery, hybrid operation, and endovascular intervention), a consensus regarding optimal surgical management has not yet been established. Case presentation A case of successful hybrid repair of distal aortic arch dissection aneurysm by dissecting KD and ARSA with debranching of right and left common carotid arteries, left subclavian artery, and stent grafting was presented. Conclusions The hybrid operation is suitable for elderly patients or those with high risks. Along with intervention, the hybrid operation needs to be developed as a minimally invasive method.
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- 2021
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194. Five cases of endoscopically noted esophageal stenosis due to abnormal aortic angiogenesis.
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Iwanaga S, Inomata H, Tabuchi M, Sasaki R, Yamaguchi N, and Nakao K
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- Humans, Aorta, Thoracic diagnostic imaging, Tomography, X-Ray Computed, Esophageal Stenosis diagnostic imaging, Esophageal Stenosis etiology, Aneurysm, Diverticulum
- Abstract
Right aortic arch is caused by a malformation of the aorta while Kommerell's diverticulum is a saccular aneurysm arising at the origin of the subclavian artery. Both diseases are caused by malformations during embryonic development and can subsequently cause compression of the esophagus and trachea due to abnormal arterial migration. Here, we report five cases of esophageal stenosis due to aortic angiogenesis anomalies. Three of the five cases had aortic running abnormalities, noted on computed tomography (CT). However, until it was observed for the first time, esophageal stricture was not recognized as an esophagogastroduodenoscopy (EGD) finding due to the lack of knowledge of diseases such as Kommerell's diverticulum even when EGD was performed during regular follow-up after treatment for esophageal cancer or other conditions. Symptoms include dysphagia and dyspnea due to stenosis of the esophagus and trachea, however, regardless of symptomatic presentation, the presence of esophageal stenosis on EGD should be considered as an effect of aortic travel abnormality or Kommerell's diverticulum. Although there have been no reports of Kommerell's diverticulum rupture due to endoscopic manipulation, gastroenterologists should consider the possibility of Kommerell's diverticulum during clinical decision making., (© 2023. Japanese Society of Gastroenterology.)
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- 2023
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195. Gore cTAG sleeve-associated maldeployment for traumatic aortic injury with aberrant right subclavian artery.
- Author
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Leonard S, Vernier B, Keyhani K, Keyhani A, Tanaka A, and Wang SK
- Abstract
A 30-year-old woman presented following a motor vehicle collision with a grade III blunt thoracic aortic injury and an aberrant right subclavian artery. Using intraoperative ultrasound and diagnostic subtraction angiography, we deployed an aortic endograft (cTAG; W.L. Gore & Associates), excluding the injury and aberrant right subclavian artery. The patient immediately lost arterial waveforms in her left arm, confirming incidental coverage of the left subclavian artery, likely due to the polytetrafluoroethylene sheath of the endograft. Her pulses returned after placement of a left subclavian chimney via retrograde brachial artery access., (© 2023 The Authors.)
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- 2023
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196. Commentary: The aberrant right subclavian artery is not so abhorrent: Central arch reconstruction for acute type B dissection
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George J. Arnaoutakis and Thomas M. Beaver
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Pulmonary and Respiratory Medicine ,Acute type ,business.industry ,medicine ,Aberrant right subclavian artery ,Surgery ,Anatomy ,Dissection (medical) ,Arch ,medicine.disease ,business - Published
- 2022
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197. Dysphagia Lusoria: A Case Report.
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F., Nik Qisti, A. S., Shahrun Niza, and R., Razrim
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- *
SUBCLAVIAN artery , *THORACIC aorta , *MEDIASTINUM , *ESOPHAGUS , *SPINE , *DISEASES - Abstract
Aberrant right subclavian artery is a rare cause of dysphagia. This is a congenital anomaly with the right subclavian artery originating from the dorsal part of the aortic arch and coursing through the mediastinum between the esophagus and the vertebral column. We report a case of a patient with chronic dysphagia caused by this condition. We further discuss the case with regards to its clinical features and options of management. [ABSTRACT FROM AUTHOR]
- Published
- 2016
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198. Total endovascular repair of aberrant right subclavian artery aneurysm using the periscope technique: a case report.
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Mazzaccaro, Daniela, Derosa, Teresa Maria, De Febis, Erika, Righini, Paolo, and Nano, Giovanni
- Abstract
Introduction Aneurysmal degeneration of aberrant right subclavian artery (ARSA) carries a relevant risk of rupture. Timely elective treatment is mandatory. Therapeutic options include open surgery repair or hybrid surgical and endovascular repair. Few reports of total endovascular approach repair have been reported. Presentation of the case We report the first case of total endovascular repair of an aneurysmal ARSA using a thoracic aortic endograft with a “periscope” covered stent into the ARSA itself. Discussion The total endovascular approach was considered for patient’s age and her poor compliance to the idea of a surgical revascularization of the ARSA, which has to be preserved since the LSA was diseased. The urgent situation did not allow for the use of a custom-made graft, so the idea of a “periscope” covered graft both to preserve the flow of the ARSA and to exclude the aneurysmal lesion seemed to be the best choice. Conclusion The “periscope” technique allowed the urgent treatment of aneurysmal ARSA with good clinical results. [ABSTRACT FROM AUTHOR]
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- 2016
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199. Prenatal Associated Features in Fetuses Diagnosed with an Aberrant Right Subclavian Artery.
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Pico, Harmony, Mancini, Julien, Lafouge, antoine, Bault, Jean-Philippe, Gorincour, Guillaume, and Quarello, Edwin
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- *
SUBCLAVIAN artery , *CONGENITAL heart disease diagnosis , *FETAL abnormalities , *CHROMOSOME abnormalities , *ULTRASONIC imaging , *DISEASES , *ANEURYSMS , *CARDIOVASCULAR system abnormalities , *CONGENITAL heart disease , *DEGLUTITION disorders , *FETAL ultrasonic imaging , *KARYOTYPES , *DISEASE complications - Abstract
Objective: The objective of this study was to determine the frequency and the nature of associated anomalies, especially malformations and chromosome abnormalities, in a population of fetuses with an aberrant right subclavian artery (ARSA).Materials and Methods: This is a 7-year descriptive study. All patients whose fetus had an ARSA diagnosed by ultrasound performed during the 1st, 2nd, or 3rd trimester of pregnancy were included, regardless of their risk of chromosomal abnormalities.Results: Between May 2007 and April 2014, an ARSA was diagnosed in 120 fetuses. The outcome was found in 108 cases (90%). ARSA was an isolated finding in 54/108 cases (50%). In 20% (22/108) of the fetuses, chromosomal abnormalities were detected. No chromosomal abnormalities were found in fetuses with an isolated ARSA. 82% (18/22) of chromosomal abnormalities were usual, such as trisomies 21 and 18, monosomy X, and 22q11.2 deletion. 21% (23/108) of the fetuses presenting an ARSA were associated with having a congenital heart disease.Conclusion: The presence of an isolated ARSA is a condition rarely associated with a chromosomal abnormality. The decision to perform an invasive karyotyping procedure under such circumstances or not may be made according to the principle of parental autonomy after extensive counselling and mostly a thorough assessment of the fetus. [ABSTRACT FROM AUTHOR]- Published
- 2016
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200. Three concurrent variations of the aberrant right subclavian artery, the non-recurrent laryngeal nerve and the right thoracic duct.
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Lee, J.-Y., Won, D.-Y., Oh, S.-H., Hong, S.-Y., Woo, R.-S., Baik, T.-K., Yoo, H.-I., Song, D.-Y., Lee, Joo-Yeon, Won, Doe-Yoon, Oh, Sae-Hoon, Hong, Sung-Young, Woo, Ran-Sook, Baik, Tai-Kyoung, Yoo, Hong-Il, and Song, Dae-Yong
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ANEURYSMS ,CARDIOVASCULAR system abnormalities ,LARYNGEAL nerves ,SUBCLAVIAN artery ,THORACIC duct ,THORACIC aorta - Abstract
We herein report a case showing three anatomical variations including the aberrant right subclavian artery (ARSA), the non-recurrent laryngeal nerve (NRLN) and the right thoracic duct in a 59-year-old male cadaver. The right subclavian artery (RSA) arose from the descending aorta next to the left subclavian artery and coursed in between the oesophagus and the thoracic vertebrae. The recurrent laryngeal nerve did not coil around the RSA but directly entered the larynx. Lastly the thoracic duct terminated into the right brachiocephalic vein. This study makes an embryological assumption that the abnormal development of the RSA had happened first and subsequently caused NRLN and the thoracic duct drainage variation. As to our knowledge, only two reports have been made previously concerning such concurrent variations. Therefore, this case report alerts anatomists and clinicians to the possibility of simultaneous occurrence of ARSA, NRLN and the right thoracic duct. [ABSTRACT FROM AUTHOR]
- Published
- 2016
- Full Text
- View/download PDF
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