Presentation
Bilateral upper limb claudication.
Patient Data
MR angiogram with gadolinium demonstrates an aberrant right subclavian artery (arrowed). Note normal loss of signal (flow void) due to blood changing direction within the descending aorta. Also, note the associated aneurysmal dilatation of this vessel.
Coronal MR angiogram further demonstrates the aberrant origin of the right subclavian artery. Incidental gallstone noted (arrowed).
3D rendered image demonstrates the aberrant subclavian anatomy. In addition, there is considerable pruning and stenoses with areas of occlusion involving the subclavian arteries more distally (arrowed).
Case Discussion
Instead of being the first branch, the right subclavian artery arises on its own as the fourth branch, after the left subclavian artery. It then hooks back posterior to oesophagus to reach the right side.
Unable to process the form. Check for errors and try again.