During routine dissection of a medical cadaver, an aberrant right subclavian artery (ARSA) was identified originating from the aortic arch. An ARSA, present in 0.2-2.5% of the population and often asymptomatic, increases the risk of surgical nerve injury during head, neck, and thoracic surgeries. ARSAs can also impinge on the esophagus and cause dysphagia or odynophagia, impinge on the trachea and cause dyspnea, or be impinged by the esophagus and/or trachea, limiting blood supply to the upper extremity. Most often, ARSAs follow a retroesophageal course, as in this case. In addition to the ARSA, the vertebral arteries were also variant and branched directly off the common carotid arteries, as opposed to the subclavian arteries, and the right recurrent laryngeal nerve was nonrecurrent. This case describes a donor with three anatomical anomalies to highlight the clinical relevance of recognizing ARSA and related variants and how to identify signs and symptoms of a symptomatic ARSA.
Meechan et al. (Sun,) studied this question.