scholarly journals Iatrogenic aortic dissection following transradial coronary angiography in a patient with an aberrant right subclavian artery

2020 ◽  
Vol 48 (8) ◽  
pp. 030006052094378
Author(s):  
Peijian Wang ◽  
Qiulin Wang ◽  
Chen Bai ◽  
Peng Zhou
Keyword(s):  
Coronary Angiography ◽  
Aortic Dissection ◽  
Aortic Arch ◽  
Subclavian Artery ◽  
Aberrant Right Subclavian Artery ◽  
Descending Aorta ◽  
Coronary Interventions ◽  
Aortic Arch Anomaly ◽  
Iatrogenic Aortic Dissection ◽  
The Right

An aberrant right subclavian artery is a congenital aortic arch anomaly in which the right subclavian artery originates from the proximal descending aorta. The presence of an aberrant right subclavian artery can make right transradial coronary interventions more difficult and even lead to complications. Iatrogenic intramural hematomas and dissection of aberrant right subclavian arteries during transradial coronary angiography have been previously reported. We herein report a case of iatrogenic aortic dissection following attempts to perform right transradial coronary angiography in a patient with an aberrant right subclavian artery. Clinicians should be vigilant for the presence of an aberrant right subclavian artery during right transradial coronary angiography and ensure gentle manipulation of wires and catheters to avoid complications.

scholarly journals Treatment with Aortic Stent Graft Placement for Stanford B-Type Aortic Dissection in a Patient with an Aberrant Right Subclavian Artery

2015 ◽  
Vol 2015 ◽  
pp. 1-5
Author(s):  
Yohei Kawatani ◽  
Yujiro Hayashi ◽  
Yujiro Ito ◽  
Hirotsugu Kurobe ◽  
Yoshitsugu Nakamura ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Stent Graft ◽  
Subclavian Artery ◽  
Distal Portion ◽  
Aberrant Right Subclavian Artery ◽  
Type B ◽  
Type B Aortic Dissection ◽  
Aortic Stent Graft ◽  
The Right ◽  
Stanford Type B

A 71-year-old man visited our hospital with the chief complaint of back pain and was diagnosed with acute aortic dissection (Debakey type III, Stanford type B). He was found to have a variant branching pattern in which the right subclavian artery was the fourth branch of the aorta. We performed conservative management for uncomplicated Stanford type B aortic dissection, and the patient was discharged. An ulcer-like projection (ULP) was discovered during outpatient follow-up. Complicated type B aortic dissection was suspected, and we performed thoracic endovascular aortic repair (TEVAR). The aim of operative treatment was ULP closure; thus we placed two stent grafts in the descending aorta from the distal portion of the right subclavian artery. The patient was released without complications on postoperative day 5. Deliberate sizing and examination of placement location were necessary when placing the stent graft, but operative techniques allowed the procedure to be safely completed.

scholarly journals Stent erosion after treatment of coarctation of right-sided aorta and successful surgical management

2019 ◽  
Vol 57 (5) ◽  
pp. 1007-1008
Author(s):  
Andreas Rukosujew ◽  
Raluca Weber ◽  
Bernd Kasprzak ◽  
Angelo Maria Dell’Aquila
Keyword(s):  
Aortic Arch ◽  
Subclavian Artery ◽  
Septal Defect ◽  
Artery Bypass ◽  
Previous History ◽  
Second Step ◽  
Descending Aorta ◽  
History Of ◽  
Aorta Replacement ◽  
The Right

Abstract We present a case of surgical treatment of a pseudoaneurysm of the right-sided aortic arch after stent implantation for primary coarctation in a 36-year-old woman with a previous history of ventricle septal defect closure in early childhood. As a first step, she underwent a left carotid to subclavian artery bypass for an aberrant left subclavian artery and as a second step a ‘beating heart’ aortic arch and descending aorta replacement via resternotomy. The postoperative course was uneventful.

scholarly journals A Five-Vessel Aortic Arch with an Anomalous Origin of Both Vertebral Arteries and an Aberrant Right Subclavian Artery

2004 ◽  
Vol 10 (4) ◽  
pp. 309-314 ◽  
Author(s):  
P.A. Brouwer ◽  
M.P.S. Souza ◽  
R. Agid ◽  
K.G. terBrugge
Keyword(s):  
Carotid Artery ◽  
Vertebral Artery ◽  
Aortic Arch ◽  
Subclavian Artery ◽  
Common Carotid Artery ◽  
Anomalous Origin ◽  
Aberrant Right Subclavian Artery ◽  
Left Vertebral Artery ◽  
Transverse Foramen ◽  
The Right

In this case presentation we describe a patient with an anomalous origin of the right vertebral artery arising from the right common carotid artery in combination with an aberrant right subclavian artery and a left vertebral artery originating from the arch between the left common carotid artery and left subclavian artery. Hence there were five vessels originating from the aortic arch. The possible embryological mechanism as well as a postulation on the importance of the level of entrance of the vertebral artery in the cervical transverse foramen is discussed.

scholarly journals Dysphagia Lusoria: A Case Report

2020 ◽  
Vol 15 (2) ◽  
Author(s):  
Nik Qisti F ◽  
Shahrun Niza AS ◽  
Razrim R
Keyword(s):  
Congenital Anomaly ◽  
Case Report ◽  
Aortic Arch ◽  
Clinical Features ◽  
Subclavian Artery ◽  
Vertebral Column ◽  
Aberrant Right Subclavian Artery ◽  
Dorsal Part ◽  
Dysphagia Lusoria ◽  
The Right

Aberrant right subclavian artery is a rare cause of dysphagia. This is a congenital anomaly with the right subclavian artery originating from the dorsal part of the aortic arch and coursing through the mediastinum between the esophagus and the vertebral column. We report a case of a patient with chronic dysphagia caused by this condition. We further discuss the case with regards to its clinical features and options of management.

ARCH Replacement in Acute Aortic Dissection Type a in Normothermia

2001 ◽  
Vol 71 (3) ◽  
pp. 282-286
Author(s):  
Ovidiu Stiru ◽  
Roxana Carmen Geana ◽  
Adrian Tulin ◽  
Raluca Gabriela Ioan ◽  
Victor Pavel ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Ct Scan ◽  
Aortic Arch ◽  
Acute Aortic Dissection ◽  
Circulatory Arrest ◽  
Type A ◽  
Ascending Aorta ◽  
Descending Aorta ◽  
The Right ◽  
Aortic Dissection Type A

The purpose of this case presentation is to present a simplified surgical technique when in a patient with acute aortic dissection type A (AAD), aortic arch, and ascending aorta is completely replaced without circulatory arrest. A 67-year old male was presented in our institution with severe chest and back pain at 12 h after the onset of the symptoms. Imaging studies by 3D contrast-enhanced thoracic computed tomography (CT-scan) and transesophageal echocardiography (TEE) revealed ascending aortic dissection towards the aortic arch, which was extending in the proximal descending aorta. We practiced emergency median sternotomy and established cardiopulmonary bypass (CBP) between the right atrium and the right femoral artery with successive cross-clamping of the ascending and descending aorta below the origin of the left subclavian artery (LSA). In normothermic condition without circulatory arrest and with antegrade cerebral perfusion, we replaced the ascending aorta and aortic arch with a four branched Dacron graft. Patient evolution was uneventful, and he was discharged, after fourteen days from the hospital. At a one-year follow-up, 3D CT-scan showed no residual dissection with a well-circulated lumen of the supra-aortic arteries. Using the described surgical approach, CPB was not interrupted, the brain was protected, and hypothermia was no used. This approach made these surgical procedures shorter, and known complications of hypothermia and circulatory arrest are avoided.Acute aortic dissection aortic type A, total arch replacement, normothermia

scholarly journals Anatomic Investigation of Two Cases of Aberrant Right Subclavian Artery Syndrome, Including the Effects on External Vascular Dimensions

Diagnostics ◽  
2020 ◽  
Vol 10 (8) ◽  
pp. 592
Author(s):  
Mitchell H. Mirande ◽  
Madelyn R. Durhman ◽  
Heather F. Smith
Keyword(s):  
Risk Assessment ◽  
Aortic Arch ◽  
Subclavian Artery ◽  
Relative Size ◽  
Aberrant Right Subclavian Artery ◽  
Normal Sample ◽  
Surgical Interventions ◽  
Brachiocephalic Trunk ◽  
The Right

The retroesophageal aberrant right subclavian artery (ARSA) is a variation of the aortic arch that occurs asymptomatically in most patients. However, when symptomatic, it is most commonly associated with dysphagia. ARSA has also been noted as a location of potentially severe aneurysms in some patients, as well as posing a risk during surgical interventions in the esophageal region. This case study analyzes two individuals with ARSA morphology in comparison to a normal sample in order to gain a better anatomical understanding of this anomaly, potentially leading to better risk assessment of ARSA patients going forward. The diameter of the ARSA vessel was found to be substantially larger than both the right subclavian artery and brachiocephalic trunk of the subjects with classic aortic arch anatomy. As many ARSA individuals are asymptomatic, we hypothesize that the relative size of the ARSA may dictate its contribution to the presence and/or severity of associated symptomatology.

scholarly journals Aberrant right subclavian artery - a marker for chromosomal abnormalities?

2012 ◽  
Vol 18 (4) ◽  
pp. 164-167
Author(s):  
C.A. Ionescu ◽  
Irina Pacu ◽  
H Haradja
Keyword(s):  
Down Syndrome ◽  
Aortic Arch ◽  
Subclavian Artery ◽  
Ductus Arteriosus ◽  
Aberrant Right Subclavian Artery ◽  
Anatomical Variant ◽  
Screening Programs ◽  
Ultrasound Evaluation ◽  
Congenital Heart Malformations ◽  
The Right

Abstract The aberrant right subclavian artery or the aberrant right subclavian artery syndrome is a rare anatomical variant of the right subclavian artery origin but it is the most common form of congenital anomaly of the aortic arch. The normal or abnormal appearance of the aortic arch can be explained by the regression or the persistence of one or other of the two embryonic aortic arches. The regression of the right aortic arch after the origin of the right subclavian artery will result in a normal aspect of left aortic arch with normal vascular anatomy. While the right ductus arteriosus is regressing, the left one persists. This anomaly is apparently found in the general population in approximately 0.5-1.4% of the cases and in approximately 3% of cases with congenital heart malformations. The present review is focus on the prevalence of aberrant right subclavian artery in Down syndrome. Until present it is known that ultrasound evaluation in the screening programs for Down syndrome is of uncertain value and studies on larger number of cases are reconsidered. In addition we suggest that the echocardiographic examination in the first and second trimesters should be included as a first step of the diagnosis in such congenital anomalies.

scholarly journals Dysphagia Lusoria: A Case of an Aberrant Right Subclavian Artery and a Bicarotid Trunk

ISRN Surgery ◽  
2011 ◽  
Vol 2011 ◽  
pp. 1-6 ◽  
Author(s):  
A. D. Rogers ◽  
M. Nel ◽  
E. P. Eloff ◽  
N. G. Naidoo
Keyword(s):  
Weight Loss ◽  
Carotid Artery ◽  
Aortic Arch ◽  
Subclavian Artery ◽  
Aberrant Right Subclavian Artery ◽  
Aortic Arch Anomalies ◽  
Dysphagia Lusoria ◽  
Marked Weight ◽  
The Common ◽  
The Right

Dysphagia Lusoria is dysphagia secondary to an aberrant right subclavian artery that has a retroesophageal course. Adachi and Williams categorized aortic arch anomalies, showing that the right subclavian artery arising in this fashion (as the final branch of the descending aortic arch) is one of the more common. However, this very rarely coexists with a bicarotid trunk. We present such a case as it is manifested in a 36-year-old lady complaining of marked weight loss and dysphagia. The diagnosis remained elusive until a CT scan of the chest was performed; angiography further delineated the pathology. It is believed that the combination of the common carotid origins with the retroesophageal course of the aberrant vessel more frequently accounts for symptoms in the absence of an aneurysm of the origin of the aberrant vessel. Several techniques to manage the aberrant vessel have been described in the literature, but we favoured open ligation and transposition to the right carotid artery.

scholarly journals Retroesophageal right subclavian artery associated with a bicarotid trunk and an ectopic origin of vertebral arteries

2021 ◽  
Author(s):  
Barbara Buffoli ◽  
Vincenzo Verzeletti ◽  
Lena Hirtler ◽  
Rita Rezzani ◽  
Luigi Fabrizio Rodella
Keyword(s):  
Carotid Artery ◽  
Vertebral Artery ◽  
Aortic Arch ◽  
Subclavian Artery ◽  
Common Carotid Artery ◽  
Distal Part ◽  
Aberrant Right Subclavian Artery ◽  
Left Vertebral Artery ◽  
Vertebral Arteries ◽  
The Right

AbstractA rare branching pattern of the aortic arch in a female cadaver is reported. An aberrant right subclavian artery originated from the distal part of the aortic arch and following a retroesophageal course was recognized. Next to it, from the left to the right, the left subclavian artery and a short bicarotid trunk originating the left and the right common carotid artery were recognized. An unusual origin of the vertebral arteries was also identified. The left vertebral artery originated directly from the aortic arch, whereas the right vertebral artery originated directly from the right common carotid artery. Retroesophageal right subclavian artery associated with a bicarotid trunk and ectopic origin of vertebral arteries represents an exceptional and noteworthy case.

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