Newly Published
Images in Anesthesiology  |   January 2019
Aberrant Right Subclavian Artery: An Important Variant of the Aortic Arch
Author Notes
  • From the Cardiothoracic Section, Department of Anesthesiology, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, North Carolina.
  • Correspondence: Address correspondence to Dr. Fernando: rfernan@wakehealth.edu
Article Information
Images in Anesthesiology / Pediatric Anesthesia
Images in Anesthesiology   |   January 2019
Aberrant Right Subclavian Artery: An Important Variant of the Aortic Arch
Anesthesiology Newly Published on January 31, 2019. doi:10.1097/ALN.0000000000002567
Anesthesiology Newly Published on January 31, 2019. doi:10.1097/ALN.0000000000002567
Aberrant right subclavian artery is an uncommon congenital anomaly of the aortic arch with incidence of 0.02 to 1.7%.1  Aberrant right subclavian artery is generally the last branch of the arch, originating distal to the left subclavian artery.2  Aberrant right subclavian artery can be diagnosed using computed tomography and transesophageal echocardiography (TEE). Computed tomography imaging shows aberrant right subclavian artery in the axial (top image, panel A; AA, aortic arch; ARSA, aberrant right subclavian artery; E, esophagus; T, trachea) and coronal (top image, panel B; LSA, left subclavian artery) planes. TEE shows aberrant right subclavian artery in the aortic arch view (bottom image, panel A) with the corresponding orthogonal view (bottom image, panel B). In 80% of cases, aberrant right subclavian artery travels retroesophageally toward the right arm, as seen on computed tomography in this case (top image, panel A). TEE also shows aberrant right subclavian artery coursing toward the esophagus. Less commonly, aberrant right subclavian artery travels between the esophagus and trachea (15%) or anterior to the trachea (5%).2