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Aberrant right subclavian artery

Aberrant right subclavian arteries (ARSA), also known as arteria lusoria, are the commonest of the aortic arch anomalies 2

Epidemiology

The estimated incidence is 0.5-2%.

Clinical presentation

They are often asymptomatic, but around 10% of people may complain of have dysphagia lusoria 3

Pathology

Course

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

Radiographic features

Fluoroscopy

An upper GI contrast study will demonstrated displacement of the contrast-filled oesophagus. This displacement by the aberrant vessels produces the so-called bayonet deformity of aberrant right subclavian artery.


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Thoracic anatomy

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