Abstract The aberrant right subclavian artery (arteria lusoria, AL) is the most common aortic-arch branching variant, occurring in approximately 0.5–2.5% of the population. Although usually asymptomatic, AL’s retroesophageal course can produce dysphagia lusoria or respiratory symptoms and is associated with Kommerell’s diverticulum and a non-recurrent right laryngeal nerve – findings with important diagnostic and procedural implications. During routine dissection at the Medical University – Sofia, we identified an AL in an 81-year-old female cadaver. The right subclavian artery arose ≈0.5 cm distal to the left subclavian artery from the transition of the aortic arch into the thoracic aorta. The aberrant vessel followed a retroesophageal course, and the brachiocephalic trunk was absent; the right and left common carotid arteries and the left subclavian artery originated separately and without other anomalies. This cadaveric case highlights a rare but clinically relevant aortic-arch variant that may complicate right transradial coronary access, endovascular and open surgical approaches to the aortic arch and neck, and neck surgery due to likely association with a non-recurrent laryngeal nerve. Further investigation combining regional cadaveric series, imaging databases, and clinical registries is warranted to clarify local prevalence and optimize diagnostic and therapeutic pathways.
Gaydarski et al. (Sun,) studied this question.