Coexistence of a Retroesophageal Aberrant Right Subclavian Artery and a Bicarotid Trunk: A Cadaveric Case Report

Introduction The major arterial branches of the aortic arch supply blood to the head, neck, and upper extremities. Typically, the brachiocephalic trunk is the first branch, followed by the left common carotid artery and then the left subclavian artery. The current cadaveric case report describes a variation with an aberrant right subclavian artery (ARSA) and a bicarotid trunk (BCT) with a nonrecurrent right inferior laryngeal nerve. Case Presentation The anterior chest wall of the donor body of a 78-year-old woman was dissected to evaluate the branches of the aortic arch. An ARSA branched from the posterior surface of the aortic arch and coursed to the right, posterior to the trachea and esophagus. A BCT arose from the superior surface and bifurcated into right and left common carotid arteries. A nonrecurrent right inferior laryngeal nerve coursed directly to the larynx from the cervical portion of the right vagus nerve. Structures of interest were measured using a vernier dial caliper. Conclusion The presence of an ARSA with a BCT is clinically important because it increases risk for dysphagia and thoracic aortic disease. Better understanding of the characteristics and prevalence of aortic arch branching variations is important for surgeons and radiologists who may encounter an ARSA or BCT in practice. Similarly, a nonrecurrent right inferior laryngeal nerve may be injured during neck procedures. Given these anatomic variants are rare, more studies are necessary to characterize the course and anatomic relationships of these structures.