Aberrant right subclavian artery with an additional arterial branch variation: A cadaveric case report

Introduction. Variations in the branching pattern of the aortic arch constitute important anatomical differences with implications for surgical interventions involving the head, neck, and upper extremities, as well as for endovascular procedures and radiological evaluations. The aim of this study was to present a retroesophageal aberrant right subclavian artery accompanied by an additional arterial branch identified during routine cadaveric dissection. Case Outline. The branching pattern of the aortic arch was examined during the thoracic dissection of a 69-year-old male cadaver used for educational purposes at the Department of Anatomy, Faculty of Medicine, Kafkas University. Examination revealed the absence of the brachiocephalic trunk. The aortic arch gave rise sequentially to the right common carotid artery, left common carotid artery, and left subclavian artery. The right subclavian artery originated from the distal portion of the aortic arch and coursed posterior to the esophagus before passing to the right side and continuing toward the upper limb. In addition, an additional arterial branch arising from the right subclavian artery was identified. This branch coursed superior to the anterior scalene muscle and rejoined the right subclavian artery distally. Conclusion. An aberrant right subclavian artery is a rare but clinically significant vascular variation. In cases exhibiting a retroesophageal course, it may cause various clinical manifestations, particularly dysphagia. Furthermore, altered anatomical relationships may result in diagnostic and surgical challenges during thoracic surgery, vascular interventions, and radiological procedures. The presence of an additional arterial branch accompanying the aberrant right subclavian artery in the present case highlights the diversity of vascular variations in the upper extremity. Awareness of such variations is important for preventing potential complications during diagnostic and interventional procedures.