Aberrant right subclavian artery

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

The estimated incidence is 0.5-2%.

They are often asymptomatic, but around 10% of people may complain of tracheo-oesophageal symptoms, almost always as dysphagia termed dysphagia lusoria 3.

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

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

CT or MRI now usually accomplishes the definitive diagnosis. Both modalities can demonstrate the aberrant branch arising from the distal left aortic arch and coursing as the right subclavian artery.

 

Thoracic anatomy
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Article information

rID: 831
Systems: Vascular, Chest
Section: Anatomy
Synonyms or Alternate Spellings:
  • Aberrant right subclavian artery (ARSA)
  • ARSA
  • Arteria lusoria

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Cases and figures

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    Figure 1: diagram and embryology
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    Dysphagia lusoria...
    Case 1: with dysphagia lusoria
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    Case 2
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    Case 3
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    Case 4
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    In the coronal im...
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    Case 7
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    Fig. 2

AP MIP
    Case 8
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    Case 9: with complicating aneurysmal dilatation
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    Right subclavian ...
    Case 10
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    3D rendered image...
    Case 11
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    MIP
    Case 12: with vascular stent
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    aberrant right su...
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    Case 14
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    Case 15: with dysphagia lusoria
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    Case 16: Barium swallow
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    Case 17
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    Case 18
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    Case 19
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    Contrast chest CT...
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