Aberrant Subclavian Artery

Definition

Definition of Aberrant Subclavian Artery
Aberrant subclavian artery, or aberrant subclavian artery syndrome refers to a rare anatomical variant of the origin of the right or left subclavian artery. This abnormality is the most common congenital vascular anomaly of the aortic arch.

Symptoms

Symptoms of Aberrant Subclavian Artery
The dysphagia may occur due to the right aberrant subclavian artery. It is also known as the dysphagia lusoria. There occurs a palsy of recurrent laryngeal nerve which is known as the Ortners syndrome. The right aberrant subclavian artery can arise from the proximal descending aorta which is known as the diverticulum of Kommerell.

Causes

Causes of Aberrant Subclavian Artery
Dysphagia lusoria is a type of dysphagia which is caused by an abnormal subclavian artery on the right. Ortner's syndrome is known as recurring laryngeal nerve palsy. The defective right subclavian artery often occurs from an open portion of the proximal descending aorta which is also termed as Kummerel or Diverticulum. In both cases of subclavian arteries, the vessel passes behind the esophagus. An impression is made on the back portion of the esophagus by the aberrant right subclavian artery while the left subclavian artery is often the one that causes anterior dislocation and acute compression on the esophagus. The left subclavian artery often causes compression of the airways. The right aberrant artery could be linked with adult dysphagia. The left aberrant artery is the one that usually causes symptoms on the obstruction of the esophagus and airway among infants and young children.

Diagnosis

Diagnosis of Aberrant Subclavian Artery
Plain radiography that comes with barium swallow could display the impressions on the esophagus and aorta. Thoracic aortography will often demonstrate the relationship of the esophagus or tracheal arch (this works simultaneously with barium swallow) and also the source of the aberrant subclavian being the fourth primary branch of the arch in the aorta. Magnetic resonance imaging (MRI) or CT scan often does definitive diagnosis. These tests show the acute condition of the narrowing airway and the retro-esophageal aberrant.

Presentation

Presentation of Aberrant Subclavian Artery
The aberrant artery usually arises just distal to the left subclavian artery and crosses in the posterior part of the mediastinum usually behind the esophagus on its way to the right upper extremity. Such course of this aberrant vessel may cause a vascular ring around a mediastinal structure. Dysphagia due to an aberrant right subclavian artery is termed dysphagia lusoria. Palsy of the recurrent laryngeal nerve is termed Ortner's syndrome. The aberrant right subclavian artery frequently arises from a dilated segment of the proximal descending aorta, the so-called Diverticulum of Kommerell.

Treatment

Treatment of Aberrant Subclavian Artery
Surgery is the only feasible treatment for this condition.