Abstract
Purpose
A right aortic arch (RAA) is a rare vascular anomaly that often coexists with an aberrant left subclavian artery (ALSA). Due to the rarity of RAA, the development of an ALSA is not well understood.
Method
We describe a case in which a 58-year-old man who was scheduled to undergo posterior decompression and fusion surgery for thoracic ossification of the posterior longitudinal ligament from Th1 to Th3 was found to have a RAA and an ALSA.
Results
Preoperative computed tomography angiography demonstrated a RAA and an ALSA. The ALSA was extremely tortuous and ran in the paraspinal muscles behind the thoracic laminae, which meant it was in the surgical field. The ALSA arose from the descending aorta and bifurcated into the left segmental arteries of Th1 and Th2, and also bifurcated into the left vertebral artery, which had a normal subsequent course. The dysplastic ALSA was considered to have developed from the thoracic intersegmental artery. Based on preoperative examination findings, we performed spinal surgery without vessel injury.
Conclusion
We report a rare case of a dysplastic ALSA that developed from the thoracic intersegmental artery with a RAA. The knowledge of this anomaly provides safety in spinal surgery of the cervicothoracic junction.
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Data availability
Data are available upon request to the corresponding author.
References
Abraham V, Mathew A, Cherian V, Chandran S, Mathew G (2009) Aberrant subclavian artery: anatomical curiosity or clinical entity. Int J Surg 7:106–109. https://doi.org/10.1016/j.ijsu.2009.01.009
Cina CS, Althani H, Pasenau J, Abouzahr L (2004) Kommerell’s diverticulum and right-sided aortic arch: a cohort study and review of the literature. J Vasc Surg 39:131–139. https://doi.org/10.1016/j.jvs.2003.07.021
Edwards JE (1948) Anomalies of the derivatives of the aortic arch system. Med Clin N Am 32:925–949. https://doi.org/10.1016/s0025-7125(16)35662-0
Gailloud P, Gregg L, Pearl MS, San Millan D (2017) Ascending and descending thoracic vertebral arteries. AJNR Am J Neuroradiol 38:327–335. https://doi.org/10.3174/ajnr.A5016
Hastreiter AR, D’Cruz IA, Cantez T, Namin EP, Licata R (1966) Right-sided aorta. I. occurrence of right aortic arch in various types of congenital heart disease. II. Right aortic arch, right descending aorta, and associated anomalies. Br Heart J 28:722–739
Haughton VM, Rosenbaum AE (1974) The normal and anomalous aortic arch and brachiocephalic arteries. In: Newton TH, Potts DG (eds) Radiology of the skull and brain. Book 2. Arteries, vol 2. Mosby, St Louis, pp 1145–1163
Ishikawa K, Endo H, Shindo K, Nomura R, Oka K, Nakamura H (2022) Aberrant right subclavian artery with right type 1 proatlantal artery and segmental dysplasia of the right internal carotid artery: a case report. Surg Radiol Anat 44:709–713. https://doi.org/10.1007/s00276-022-02950-7
Janssen M, Baggen MG, Veen HF, Smout AJ, Bekkers JA, Jonkman JG, Ouwendijk T (2000) Dysphagia lusoria: clinical aspects, manometric findings, diagnosis, and therapy. Am J Gastroenterol 95:1411–1416. https://doi.org/10.1111/j.1572-0241.2000.02071.x
Lasjaunias P, Berenstein A (1987) Spinal and spinal cord arteries and veins. In: Lasjaunias P, Berenstein A (eds) Surgical Neuroangiography 3. Functional vascular anatomy of Brain, spinal cord and spine. Springer-, Berlin, pp 15–87
Mamopoulos AT, Luther B (2014) Congenital subclavian steal syndrome with multiple cerebellar infarctions caused by an atypical circumflex retroesophageal right aortic arch with atretic aberrant left subclavian artery. J Vasc Surg 60(3):776–779. https://doi.org/10.1016/j.jvs.2013.06.086
Otsuka T, Izumi T, Nishihori M, Tsukada T, Araki Y, Yokoyama K et al (2021) Management of asymptomatic vertebral artery injury caused by a cervical pedicle screw malposition: two case reports. NMC Case Rep J 8:713–717. https://doi.org/10.2176/nmccrj.cr.2021-0062
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KI: project development, data collection and analysis, literature research and manuscript writing/editing. YO: literature research and manuscript editing. MF: data analysis and literature research. HE: literature research and manuscript editing. HN: project development and total management.
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Ishikawa, K., Ohtake, Y., Fukuda, M. et al. Dysplastic aberrant left subclavian artery originating from a thoracic intersegmental artery associated with a right aortic arch. Surg Radiol Anat 46, 519–522 (2024). https://doi.org/10.1007/s00276-024-03333-w
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DOI: https://doi.org/10.1007/s00276-024-03333-w