Right-sided cervical aortic arch

Cervical aortic arch is a rare congenital anomaly that should be suspected in a patient with a large pulsatile supraclavicular mass. Pulse and blood pressure abnormalities are frequently present, as are symptoms suggestive of an intrathoracic vascular ring. Diminution of femoral pulses by compression of the supraclavicular mass against cervical vertebrae is a valuable clinical maneuver for diagnosis of this condition, which can be confirmed on aortography.A 30-year-old woman with a right-sided aortic arch is the twelfth reported case of this anomaly. This is the first case where the ipsilateral external carotid vessel arises separately from the intrathoracic portion of the aorta instead of from the apex of the cervical arch. The actual redundant nature of the cervical arch plus the separate origins of the right internal and external carotid support, but do not prove, the thesis that the cervical arch represents a persistence of the embryonic third arch.