A retroesophageal right subclavian artery with the right vertebral artery originating from the right common carotid artery

The right subclavian artery was found to be retroesophageal, and the right vertebral artery originated from the right common carotid artery in a 46-year-old female cadaver. The right subclavian artery stemmed from the upper portion of the thoracic aorta, posterior and inferior to the origin of the normal left subclavian artery. The right and left common carotid arteries originated from the aortic arch in close proximity. Compression of the trachea anteriorly could not be demonstrated. The right inferior laryngeal nerve was nonrecurrent. A brief review of the literature shows the importance of knowledge concerning the aberrant right subclavian artery for the roentgenologist and the surgeon in the treatment of patients with this vascular anomaly.     

右锁骨下动脉和右颈总动脉变异1例

正对1具男性尸体进行解剖时,发现右锁骨下动脉和右颈总动脉直接起自于主动脉弓,致主动脉弓分支变异(图1),而正常的右锁骨下动脉和右颈总动脉起自头臂干[1],相对于国内李永胜[2]等人的报道,此类变异数值、具体起点均有差异。根据《中国人解剖学数值》,本例锁骨下动脉变异出现率为1.48%,为积累国人解剖学数据和为临床治疗提供参考,现报     

Bilateral aberrant origin of the inferior thyroid artery from the common carotid artery

The thyroid gland is mainly supplied by the superior and inferior thyroid arteries, with the latter being its principal arterial supply in adults. The inferior thyroid artery usually arises from the thyrocervical trunk, and less frequently from the subclavian artery. Rarely, it may originate from the vertebral artery or the common carotid artery. In the present report, we describe a unique case of a 56-year-old patient, undergoing total thyroidectomy and level VI lymph node dissection for papillary thyroid carcinoma, with aberrant origin of both inferior thyroid arteries from the common carotid arteries.     

Association of the truncus bicaroticus, common trunk of the left subsclavian and vertebral arteries, and retroesophageal right subclavian artery. Case report

We present a rare case of combined anomalies of the aortic arch. At its convexity, the arch of aorta gave rise, from right to left, first to the truncus bicaroticus and then to the common trunk of the left subclavian and left vertebral artery. A retro-esophageal right subclavian artery arose from the dorsal aspect of the arch, distally from the common trunk of the left vertebral artery and left subclavian artery. The combination of these anomalies has not been described before and may have important clinical implications.     

锁骨下动脉、颈总动脉和椎动脉分叉处血流动力学数值模拟

目的:探讨锁骨下动脉、颈总动脉和椎动脉分叉处的血流动力学特性,分析该处发生血管狭窄引起大脑供血不足的 血流动力学原因。方法:采用内蒙古民族大学附属医院神经内科提供的CT数据,应用医学建模软件MIMICS20.0将患者 二维CT数据进行三维血管重建,经过网格划分及边界条件设置后导入计算流体力学软件FLUENT14.5中。计算和分析 不同血液入口速度的锁骨下动脉、颈总动脉和椎动脉分叉处的血流动力学特性。结果:在血液入口速度不同的情况下,锁 骨下动脉、颈总动脉和椎动脉分叉处的血液流场分布、血液压力分布和血管壁面切应力分布有显著变化。在血液入口速 度增大时,锁骨下动脉分叉处和颈总动脉分叉处的血液流速快、血管壁压力大,颈总动脉内侧血管壁面切应力大,但锁骨 下动脉分叉处和颈总动脉分叉处血管壁面切应力数值和变化幅度小,属于低切应力区。结论:通过血流动力学数值模拟 研究,分析锁骨下动脉、颈总动脉和椎动脉分叉处易发生粥样斑块病变导致大脑供血不足的血流动力学原因。     

左椎动脉发自主动脉弓伴双侧颈总动脉高位分叉1例

根据《中国人解剖学数值》,左侧椎动脉直接起源于主动脉弓占(3.47±0.45)%。另外,一般解剖学教科书常把甲状软骨上缘作为颈总动脉分叉的高度。椎动脉起源于主动脉弓或颈总动脉     

Anomalous origin and cervical course of the vertebral artery in the presence of a retroesophageal right subclavian artery

The vertebral artery is usually described as the first branch of the subclavian artery, originating medial to the scalenus anterior muscle. During its cervical course, the vertebral artery presents a prevertebral segment and then enters the foramen transversarium of the sixth cervical vertebra. We describe a case of an unusual origin and course of the right vertebral artery in a cadaver specimen wherein the right vertebral artery originates from the right common carotid artery at the inferior border of the thyroid gland. In its cervical course the vertebral artery ascends outside and anteriorly to the foramen transversarium of vertebrae C VI to C III, and enters the foramen transversarium of the axis. In the same specimen, a retroesophageal right subclavian artery is also present. These vascular abnormalities are presented for physicians to keep in mind such variations during diagnostic investigation and surgical procedures of the neck.     

Anatomical characteristics of two cases of aberrant right subclavian artery

Anatomical Science International - An aberrant right subclavian artery is a branching variation of the aortic arch. We encountered two female cadavers with an aberrant right subclavian artery...     

Unusual association of pulmonary artery sling with right aortic arch and aberrant left subclavian artery

We present an unusual case of vascular sling, tracheal stenosis by complete cartilaginous ring, and aberrant left subclavian artery with right aortic arch that underwent successful surgical repair for the sling. These abnormalities were suspected from unusual multiple indentations found on esophagogram. Complete preoperative diagnosis was established with chest computerized tomogram combined with angiography.     

Absence of the right common carotid artery

In a 33-year-old male patient with multiple sclerosis, brain magnetic resonance imaging incidentally showed a narrow right intracranial internal carotid artery. Gadolinium-enhanced magnetic resonance angiography showed absence of the right common carotid artery. Right external and internal carotid arteries arose separately from the ipsilateral innominate artery and subclavian artery, respectively. Color-Doppler ultrasound confirmed this finding. Embriologically, the case could be interpreted as the disappearance of the third aortic arch with persistence of the carotid duct connecting the third and fourth aortic arches.     

Simultaneous occurrence of an aberrant right subclavian artery and accessory lobe of the liver

We herein report a case showing the simultaneous occurrence of an aberrant right subclavian artery (ARSA) and accessory lobe of the liver in a 75-year-old female cadaver. In the thorax, the left aortic arch branched into the right common carotid artery, left common carotid artery, left subclavian artery, and ARSA, in that order. The ARSA was dilated at its origin to form Kommerell’s diverticulum and coursed behind the esophagus. This diverticulum seemed to press the esophagus. A right-sided thoracic duct was identified that emptied into the angulus venosus. In the right-sided neck, a nonrecurrent laryngeal nerve was found. In the abdominal cavity, an accessory lobe protruded from the anterior margin of the left liver lobe. The accessory lobe was separated from the left lobe by a transverse furrow on the anterior side. We discuss possible common causes of these anomalies during development.     

Anomalous thymic branch of the right common carotid artery

A previously unreported anomalous thymic artery that branched from the anterior aspect of right common carotid artery approximately 1 cm above bifurcation of the brachiocephalic artery was found during routine dissection. It traveled inferiorly through a plexus of inferior thyroid veins for 6 cm in front of the brachiocephalic artery and crossed the anterior surface of the trachea where it divided into two branches that supplied the right and left lobes of the thymus. The development and blood supply of the thymus and their clinical anatomy are reviewed. Clin. Anat. 11:346–348, 1998. © 1998 Wiley-Liss, Inc.     

Hemifacial spasm patient with ipsilateral total absence of common carotid artery, vertebral artery and aneurysm of the contralateral internal carotid artery

We present a case of a 45-year-old male patient with left hemifacial spasm for 6 years. Magnetic resonance tomographic angiography confirmed that there were small vessels adjacent to the left facial nerve root entry zone, but the left internal carotid artery (ICA) was absent. Magnetic resonance angiography using three-dimensional time of flight technique showed the absence of the left ICA and vertebral artery, But the presence of a 6-mm aneurysm in the bifurcation of the right internal carotid artery. These abnormal arterial structures were further confirmed by angiogram. Aortic arch angiogram revealed a right-sided aortic arch and the Subclavian steal phenomenon. The left common carotid artery and the left Subclavian artery were absent. Right vertebral angiography showed retrograde filling of the left vertebral artery. The left upper limb was fed by this artery. The aneurysm was successfully clipped. Post-operatively, the hemifacial spasm was weakened. However, the operation did not change the neurovascular positional relationship, thus we advised follow-up visits. Cerebral artery anomalies should be taken into consideration when performing imaging and surgical corrections in patients with hemifacial spasm.     

A case of retroesophageal right subclavian artery, with special reference to the second intercostal artery, retroesophageal right vertebral artery, and thoracic duct

We report a case of retroesophageal right subclavian artery identified in a 59-year-old Japanese female during routine dissection in Nagasaki University School of Medicine. This kind of variation is relatively rare; however, reports of such cases have accumulated. We paid attention to the intersegmental arteries and above all, the second intercostal artery. On the other hand, there have been reports of a retroesophageal right vertebral artery, although such cases are extremely rare. It is considered that both retroesophageal arteries are formed by similar mechanisms. In other words, the distal part of the right dorsal aorta remained in such cases. However, in the case of a retroesophageal right vertebral artery, there might be the possibility of intercostal arteries developing into the vertebral artery, and we discuss such points here.     

右锁骨下动脉起始行程异常1例

笔者在教学中遇到右锁骨下动脉异位1例，现报道如下：     

An aberrant cerebellar artery originating from the internal carotid artery

The aberrant origin of the cerebellar arteries from anterior cerebral circulation is a quite rare vascular variation. Herein, we report a 52-year-old white female with angiographically occult subarachnoid hemorrhage. Left superior and anterior inferior cerebellar arteries were not detected. An aberrant cerebellar artery was noted to arise from the left cavernous internal carotid artery and terminated in the distribution of the ipsilateral superior and anterior inferior cerebellar arteries. This variant artery might likely have resulted from an abnormal regression of fetal anterior-to-posterior circulation connections, and may represent a fetal-type cerebellar artery. A review of the anatomy and clinical significance of the variant is presented.     

Interpretation of multi-detector computed tomography images before dissection may allow detection of vascular anomalies: a postmortem study of anomalous origin of the right subclavian artery and the right vertebral artery

The Graduate School of Medicine at Chiba University is planning to introduce computed tomography (CT) images of donated cadavers to the gross anatomy laboratory. Here we describe an anomaly of the right subclavian artery that was detected by interpretation of CT images prior to dissection. The anomaly was verified to be the right subclavian artery, as the last branch of the aortic arch, by subsequent dissection of the cadaver. We also identified an anomalous origin of the right vertebral artery by dissection. This anomaly was also visible on CT images, although it had not been recognized in the first interpretation of the CT images. Our results suggest that branching anomalies of arteries with a diameter of >1?cm are detectable on CT images even without the injection of contrast medium. We also discuss the utility of interpreting CT images prior to dissection as a means by which medical students can gain a better understanding of human body during the gross anatomy laboratory.