Right aberrant subclavian artery with esophageal web
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 vascularanomaly of the aortic arch. The aberrant right subclavian artery frequently arises from a dilated segment of the proximal descending aorta, the so-called Diverticulum of Kummerel.
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 vascularanomaly of the aortic arch. The aberrant right subclavian artery frequently arises from a dilated segment of the proximal descending aorta, the so-called Diverticulum of Kummerel.
The aberrant right subclavian artery usually arises just distal to the left subclavian artery and passes posterior to the mediastinum on its way to the right upper extremity. Such course of this aberrant vessel may cause a vascular ring around a mediastinal structure. In both types of aberrant subclavian arteries, the vessel runs behind the oesophagus. The aberrant right subclavian artery produces an impression on the back of the oesophagus while the left one usually causes anterior displacement and severe compression of the oesophagus. The latter also frequently causes airway compression. The right aberrant arterycan be associated with dysphagia in adults while the left usually causes symptomatic airway and oesophageal obstruction during infancy or early childhood.
Dysphagia due to an aberrant right subclavian artery is termed dysphagia lusoria. Palsy of the recurrent laryngeal nerve is termed Ortner\'s syndrome.
Plain radiography with barium swallow displays posterior impression on the esophagus. Thoracic aortography demonstrates the relationship of the arch to the trachea or oesophagus (simultaneous bariumswallow) and origin of the aberrant subclavian as the fourth major branch of the aortic arch.