Arteria lusoria aneurysm Murad Abdelsalam, MD,a Hiren Shingala, MD,b David Loran, MD,c and Brijeshwar Maini, MD,d Peoria, Ill; and Harrisburg, Pa
A 54-year-old woman with history of chronic dysphagia and persistent nonproductive cough presented with worsening of her symptoms over few months. Initial roentgenogram and computed tomography of the chest were normal. An upper endoscopy (A) demonstrated an area of extrinsic compression in the middle third of the esophagus. Bronchoscopy (B) revealed a midtracheal posterior extrinsic compression by a pulsatile mass. Therefore, computed tomography angiography (C) was performed that showed aberrant right subclavian artery with aneurysmal dilatation compressing on the trachea and esophagus, aneurysmal dilatation of both subclavian arteries arising from diverticulum of Kommerell, and a common origin of carotid arteries (truncus bicaroticus). Volume-rendered computed tomography of the aortic arch and subclavian arteries is also shown (D). Because of her severe symptomology and the inherent risk of aneurysm rupture, a successful hybrid endovascular-surgical approach was undertaken. Aberrant right subclavian artery, also called arteria lusoria, was first described by Bayford1 in 1794. It is the most common abnormality of the aortic arch. Usually, patients are asymptomatic but progressive dysphagia or dyspnea might occur. REFERENCE 1. Bayford D. An account of a singular case of obstructed deglutition. Vol 2. Memoirs Med Soc London 1794:275-86. Submitted Jun 24, 2013; accepted Aug 21, 2013. From the Department of Internal Medicine, University of Illinois College of Medicine at Peoria, Peoriaa; and the Department of Pulmonology,b Department of Cardiothoracic Surgery,c and Department of Cardiology,d Pinnacle Health Cardiovascular Institute, Harrisburg. Author conflict of interest: none. E-mail: [email protected]. The editors and reviewers of this article have no relevant financial relationships to disclose per the JVS policy that requires reviewers to decline review of any manuscript for which they may have a conflict of interest. J Vasc Surg 2014;60:1060 0741-5214/$36.00 Copyright Ó 2014 by the Society for Vascular Surgery. http://dx.doi.org/10.1016/j.jvs.2013.08.043
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A 54-year-old woman with history of chronic dysphagia and persistent nonproductive cough presented with worsening of her symptoms over few months. Initial roentgenogram and computed tomography of the chest were normal. An upper endoscopy (A) demonstrated an area of extrinsic compression in the middle third of the esophagus. Bronchoscopy (B) revealed a midtracheal posterior extrinsic compression by a pulsatile mass. Therefore, computed tomography angiography (C) was performed that showed aberrant right subclavian artery with aneurysmal dilatation compressing on the trachea and esophagus, aneurysmal dilatation of both subclavian arteries arising from diverticulum of Kommerell, and a common origin of carotid arteries (truncus bicaroticus). Volume-rendered computed tomography of the aortic arch and subclavian arteries is also shown (D). Because of her severe symptomology and the inherent risk of aneurysm rupture, a successful hybrid endovascular-surgical approach was undertaken. Aberrant right subclavian artery, also called arteria lusoria, was first described by Bayford1 in 1794. It is the most common abnormality of the aortic arch. Usually, patients are asymptomatic but progressive dysphagia or dyspnea might occur. REFERENCE 1. Bayford D. An account of a singular case of obstructed deglutition. Vol 2. Memoirs Med Soc London 1794:275-86. Submitted Jun 24, 2013; accepted Aug 21, 2013. From the Department of Internal Medicine, University of Illinois College of Medicine at Peoria, Peoriaa; and the Department of Pulmonology,b Department of Cardiothoracic Surgery,c and Department of Cardiology,d Pinnacle Health Cardiovascular Institute, Harrisburg. Author conflict of interest: none. E-mail: [email protected]. The editors and reviewers of this article have no relevant financial relationships to disclose per the JVS policy that requires reviewers to decline review of any manuscript for which they may have a conflict of interest. J Vasc Surg 2014;60:1060 0741-5214/$36.00 Copyright Ó 2014 by the Society for Vascular Surgery. http://dx.doi.org/10.1016/j.jvs.2013.08.043
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