Aberrant right subclavian artery: a case of vertebrobasilar insufficiency

Author:

Kimyaghalam A1,Gabay A2,Singh K1

Affiliation:

1. Department of Vascular Surgery, State Island University Hospital , Staten Island, NY 10305 , USA

2. Main Line Health , Philadelphia, PA , USA

Abstract

Abstract Aberrant right subclavian artery (ARSA) is a rare congenital malformation, wherein the aorta gives rise to the right subclavian artery as a branch off the aortic arch distal to the takeoff of the left subclavian artery. We presented a case of a patient with ARSA that manifested vertebrobasilar symptoms. PubMed search was preformed using keywords ‘aberrant right subclavian artery’, ‘right subclavian steal’ and ‘vertebrobasilar’, which generated nine articles. We found only seven case reports through a PubMed search that discuss ARSA in association with Subclavian steal syndrome. Approximately 71% (n = 5) of the patients in our literature review manifested with signs and symptoms of vertebrobasilar insufficiency. Given the complex anatomy in this condition, treatment should be aimed at symptom resolution. Carotid-subclavian bypass ultimately resolved the symptoms in our patient. Management in symptomatic patient is surgical. In addition to open technique, endovascular interventions can be an option.

Publisher

Oxford University Press (OUP)

Subject

Surgery

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