Abnormal origin of right subclavian artery - A cadaveric study

Abstract

Background: During early embryonic life, the aortic arch undergoes complex development and normally results in the formation of a left aortic arch from which three arteries arise: (1) the brachiocephalic artery, which divides into the right common carotid and right subclavian arteries, (2) the left common carotid artery and (3) the left subclavian artery. In the present study we found an aberrant right subclavian artery arising from the arch of aorta distal to the left common carotid artery. Aims & Objective: Abnormalities of branches of arch of aorta are not uncommon and they have been identified more frequently with increasing use of imaging studies. However, the clinician should be aware of the wide range of anomalies that occur in the arch & the great vessels. This could help in adequately managing these variations in emergency approaches to the arch & the great vessels when imaging studies are not available. Our aim is to report the occurrence of the abnormal origin of right subclavian artery in a sample of western Indian population. Material and Methods: Present study was conducted on embalmed cadavers in Anatomy Department at various medical colleges in Gujarat. Branches of arch of aorta were dissected & observed for any variation. Results: A total of 70 cadavers were dissected. In one cadaver we found abnormal origin of right subclavian artery from the arch of aorta. The anomalous artery was passing behind the oesophagus. (1.43%, n = 70) Conclusion: An aberrant right subclavian artery is a rare vascular anomaly & it is also an unusual cause of problems with the passage of solid food through the oesophagus. Recently it has been suggested that it occurs more frequently in patients with Down syndrome. Knowledge of this anomaly is important while evaluating feeding difficulties in patients with Down syndrome as well as in preventing vascular complications in patients with aberrant right subclavian artery.