Introduction: The aortic arch gives rise to the brachiocephalic trunk, left common carotid artery, and left subclavian artery, forming one of several recognized branching patterns. Among these variants, the aberrant right subclavian artery (ARSA) is the most common. ARSA originates distal to the left subclavian artery and most often courses posterior to the esophagus, a configuration identifiable on imaging. Although frequently asymptomatic, its retroesophageal trajectory may compress adjacent structures such as the esophagus or trachea, producing symptoms such as dysphagia lusoria.
Case Presentation: During routine curricular dissection at RVU MCOM, a single case of ARSA was identified in a female donor. Further dissection revealed the ARSA as a fourth branch of the aortic arch, crossing the midline posterior to the esophagus. No additional vascular anomalies were present, and the caliber of the vessel appeared consistent with the other aortic branches. This anatomy reflects abnormal regression of the right fourth aortic arch with persistence of the right dorsal aorta during embryologic development. We aim to describe our finding of cadaveric ARSA and discuss its embryologic, clinical, and educational implications.
Conclusion: Awareness of ARSA is essential during thoracic surgery and right radial or brachial catheterization, where unexpected vascular trajectories may alter procedural planning. Preprocedural recognition on imaging may help prevent such catheterization difficulties or operative complications. This cadaveric finding highlights the educational value of anatomic variation in preparing trainees for radiologic interpretation and clinical decision making.
Case Presentation: During routine curricular dissection at RVU MCOM, a single case of ARSA was identified in a female donor. Further dissection revealed the ARSA as a fourth branch of the aortic arch, crossing the midline posterior to the esophagus. No additional vascular anomalies were present, and the caliber of the vessel appeared consistent with the other aortic branches. This anatomy reflects abnormal regression of the right fourth aortic arch with persistence of the right dorsal aorta during embryologic development. We aim to describe our finding of cadaveric ARSA and discuss its embryologic, clinical, and educational implications.
Conclusion: Awareness of ARSA is essential during thoracic surgery and right radial or brachial catheterization, where unexpected vascular trajectories may alter procedural planning. Preprocedural recognition on imaging may help prevent such catheterization difficulties or operative complications. This cadaveric finding highlights the educational value of anatomic variation in preparing trainees for radiologic interpretation and clinical decision making.