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Surgical radiologic anatomy of aberrant right subclavian artery (arteria lusoria). A study on 160 CT scans.
Author(s) -
Settembre Nicla,
Malikov Sergueï,
Jean Fanette,
Bouziane Zakariyae
Publication year - 2016
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.30.1_supplement.556.2
Subject(s) - medicine , ostium , radiology , surgery
The Arteria lusoria (AL) is the most common anatomical variation of the supra‐aortic trunks. The symptomatic forms are rare and occur by compression of the oesophagus (dysphagia lusoria) or aneurismal transformation of the AL with a risk of rupture or embolism including posterior stroke or ischemia of the hand. The AL may be involved in aortic aneurismal pathology type or dissection and may complicate endovascular management. The aim of this study is to firstly clarify the morphology of the AL and the situation of its ostium in relation to nearby arteries; secondly we assessed the feasibility of interventional treatment in patients requiring intervention. Patients and methods we analyzed 160 Angio‐CT scan from patients with this anatomical variation. We made multiple measurements of diameter and distance, and collected different morphological data, by a standardized protocol. The Student test was used to compare our results. Throughout these results we assessed the practical feasibility of this method. Results AL is associated with the presence of a bicarotidien common trunk in 49% of cases, and has a conical expansion at its ostium (diverticulum Kommerell) in 66% of patients. The average distance between the right and left subclavian arteries is 2.4 mm. The diameter of the AL is compatible with endovascular occlusion systems. The presence of a diverticulum Kommerell requires the use of permanent materials to prevent migration into the aorta. By using these data we were able to treat 4 patients with symptomatic AL, the feasibility of the hybrid surgery was confirmed with good results. Conclusion We were able to identify the morphological characteristics of the AL, we found a significant difference in diameter between the two subclavian arteries. The presence of a Kommerell diverticulum is frequent. Our work helps to plan the endovascular or hybrid treatment and to anticipate the technical limitations of those interventions.