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Aberrant right subclavian artery

An aberrant right subclavian artery (ARSA) is the most common of the aortic arch anomalies 2


The incidence is estimated at ~ 0.5-2 %.

Clinical presentation

It is often asymptomatic but ~ 10% of people can have dysphagia lusoria 3

Radiographic features

In a barium swallow the displacement of the aberrant vessels produces the so-called bayonet deformity of aberrant right suvclavian artery.



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

  • 80% posterior to oesophagus
  • 15% between oesophagus and trachea
  • 5% anterior to the trachea
Associated anomalies


Related articles

Thoracic anatomy

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