EURORAD ESR

Case 13605

Right-sided aortic arch with aberrant left subclavian artery

Author(s)
Pradosh Kumar Sarangi1, Pratisruti Hui1, Sasmita Parida2

(1) Residents,
(2) Associate professor
Department of radiodiagnosis,
SCB medical college & hospital,
Cuttack, India
Email: lipu90sarangi@gmail.com
 
Patient
female, 60 year(s)
 
 
  • Figure 1
    Chest radiograph PA view

    Absent left aortic contour, presence of right aortic knob (red arrow), both hemidiaphragms are flat and low in position.

     
    Area of Interest: Arteries / Aorta; Cardiovascular system; Imaging Technique: Conventional radiography; Procedure: Diagnostic procedure; Special Focus: Congenital;
     
     
  • Figure 2
    Scanogram
     

    Right aortic arch (white arrow), distal tracheal deviation to the left (yellow arrow).

     
    Area of Interest: Arteries / Aorta; Mediastinum; Imaging Technique: Conventional radiography; Plain radiographic studies; Procedure: Diagnostic procedure; Special Focus: Congenital;

    Lateral scanogram showing right aortic arch with right descending thoracic aorta.

     
    Area of Interest: Arteries / Aorta; Imaging Technique: Conventional radiography; Plain radiographic studies; Procedure: Diagnostic procedure; Special Focus: Congenital;
     
     
  • Figure 3
    CECT Thorax
     

    Four vessels from the right aortic arch in the following order. Left CCA (yellow arrow), right CCA(green arrow), right SA(blue arrow), left SA (red arrow). Purple arrow-left subclavian vein, T-trachea, O-oesophagus

     
    Area of Interest: Anatomy; Arteries / Aorta; Imaging Technique: CT; Procedure: Contrast agent-intravenous; Diagnostic procedure; Special Focus: Congenital;

    White arrow- right aortic arch, yellow arrow- left CCA, red arrow- aberrant left subclavian artery coursing posterior to oesophagus, S-superior vena cava, T-trachea, O-oesophagus

     
    Area of Interest: Arteries / Aorta; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Congenital;

    Aberrant left subclavian artery (red arrow) arising from Kommerell’s diverticulum (white arrow), a focal dilatation of the arch. Yellow arrow-left CCA, S-superior vena cava

     
    Area of Interest: Arteries / Aorta; Imaging Technique: CT; Procedure: Contrast agent-intravenous; Diagnostic procedure; Special Focus: Congenital;

    The descending aorta (D)continues inferiorly on the right side of the vertebral column.

     
    Area of Interest: Arteries / Aorta; Imaging Technique: CT; Procedure: Contrast agent-intravenous; Special Focus: Congenital;

    Thoracic aorta (white arrow), descending on the right side of the spine then turning to the left to enter the aortic hiatus at normal position.

     
    Area of Interest: Arteries / Aorta; Imaging Technique: CT; Procedure: Contrast agent-intravenous; Special Focus: Congenital;

    Aortic arch (white arrow) on the right side of distal trachea.

     
    Area of Interest: Arteries / Aorta; Imaging Technique: CT; Procedure: Contrast agent-intravenous; Special Focus: Congenital;
     
     
  • Figure 4
    3D volume-rendering images
     

    Anterior view: Note the origin of 4 vessels from right-sided aortic arch in the following order. 1. left CCA 2. right CCA 3. right subclavian artery 4. left subclavian artery (last branch)

     
    Area of Interest: Anatomy; Arteries / Aorta; Imaging Technique: CT-Angiography; Procedure: Computer Applications-3D; Computer Applications-Detection, diagnosis; Special Focus: Congenital;

    Anterior view, slightly rotated: 1. left CCA 2. right CCA 3. right subclavian artery 4. left subclavian artery (last branch) 5. Kommerell’s diverticulum 6. right-sided aortic arch

     
    Area of Interest: Arteries / Aorta; Imaging Technique: CT-Angiography; Procedure: Computer Applications-3D; Computer Applications-Detection, diagnosis; Special Focus: Congenital;

    Posterior view: Aberrant left subclavian artery (4) arising from Kommerell’s diverticulum(5), a focal dilatation of the arch. 6. right-sided aortic arch 7. descending aorta.

     
    Area of Interest: Anatomy; Arteries / Aorta; Imaging Technique: CT-Angiography; Procedure: Computer Applications-3D; Special Focus: Congenital;

    Lateral view: 1. left CCA 2. right CCA 3. right subclavian artery 4. left subclavian artery (last branch) 5. Kommerell’s diverticulum 6. right-sided aortic arch 7. descending aorta.

     
    Area of Interest: Arteries / Aorta; Imaging Technique: CT-Angiography; Procedure: Computer Applications-3D; Computer Applications-Detection, diagnosis; Special Focus: Congenital;

    Lateral view, slight rotation: 1. left CCA 2. right CCA 3. right subclavian artery 4. left subclavian artery (last branch) 5. Kommerell’s diverticulum 6. right-sided aortic arch 7. descending aorta

     
    Area of Interest: Arteries / Aorta; Imaging Technique: CT-Angiography; Procedure: Computer Applications-3D; Computer Applications-Detection, diagnosis; Special Focus: Congenital;
     
     
Absent left aortic contour, presence of right aortic knob (red arrow), both hemidiaphragms are flat and low in position.
 
Right aortic arch (white arrow), distal tracheal deviation to the left (yellow arrow).
 
Lateral scanogram showing right aortic arch with right descending thoracic aorta.
 
Four vessels from the right aortic arch in the following order. Left CCA (yellow arrow), right CCA(green arrow), right SA(blue arrow), left SA (red arrow). Purple arrow-left subclavian vein, T-trachea, O-oesophagus
 
White arrow- right aortic arch, yellow arrow- left CCA, red arrow- aberrant left subclavian artery coursing posterior to oesophagus, S-superior vena cava, T-trachea, O-oesophagus
 
Aberrant left subclavian artery (red arrow) arising from Kommerell’s diverticulum (white arrow), a focal dilatation of the arch. Yellow arrow-left CCA, S-superior vena cava
 
The descending aorta (D)continues inferiorly on the right side of the vertebral column.
 
Thoracic aorta (white arrow), descending on the right side of the spine then turning to the left to enter the aortic hiatus at normal position.
 
Aortic arch (white arrow) on the right side of distal trachea.
 
Anterior view: Note the origin of 4 vessels from right-sided aortic arch in the following order. 1. left CCA 2. right CCA 3. right subclavian artery 4. left subclavian artery (last branch)
 
Anterior view, slightly rotated: 1. left CCA 2. right CCA 3. right subclavian artery 4. left subclavian artery (last branch) 5. Kommerell’s diverticulum 6. right-sided aortic arch
 
Posterior view: Aberrant left subclavian artery (4) arising from Kommerell’s diverticulum(5), a focal dilatation of the arch. 6. right-sided aortic arch 7. descending aorta.
 
Lateral view: 1. left CCA 2. right CCA 3. right subclavian artery 4. left subclavian artery (last branch) 5. Kommerell’s diverticulum 6. right-sided aortic arch 7. descending aorta.
 
Lateral view, slight rotation: 1. left CCA 2. right CCA 3. right subclavian artery 4. left subclavian artery (last branch) 5. Kommerell’s diverticulum 6. right-sided aortic arch 7. descending aorta
 
 
 
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