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Despite its rare incidence, an occlusion or near-occlusion of an aberrant right subclavian artery (lusorian artery) presents a challenging pathology to treat. While open surgical approaches have been regarded as first-line treatment for a long time, endovascular solutions have proven over the last years to be a less invasive yet effective alternative, like in many other vascular conditions. We report on a 47-year-old female complaining of dizziness and vertigo, together with a weakness in the right arm aggravated by manual activities. Other than obesity (BMI of 34 kg/m2) and smoking (45 Pack years), no other relevant history was present. A series of intensive neurological diagnostics revealed no pathological findings. However, duplex ultrasound of the neck vessels showed a retrograde flow in the right vertebral artery secondary to a subtotal occlusion of the right Subclavian Artery (SA). Complimentary CT-angiography additionally revealed an aberrant origin of the SA from the descending aorta. Due to the location of the lesion and the expected technical difficulties in obese patients, we opted for an interventional endovascular angioplasty. Through this case report we aim to present the role of endovascular interventions in the treatment of occlusions and stenoses in the context of an abnormal anatomy.

Subclavian Steal Syndrome Due to a Subtotal-Occlusion of an Aberrant Right Subclavian (Lusorian) Artery-A Case Report