Erik Morales, Hawkins Sellier, Melody Zaki, Bryan Daniel Meraz, and Ahmed Alassal M.D
USA.
This report describes the incidental discovery of a rare cadaveric anomaly—an aberrant right subclavian artery
(ARSA)—encountered during a routine dissection in a first-year medical anatomy course. The subject, an 88-year-old
female, had Clostridium difficile colitis as the primary cause of death, with pneumonia listed as a contributing factor. The
ARSA, originated as the final branch of the aortic arch, distal to the left subclavian artery, and coursed posteriorly to the
esophagus and trachea toward right upper extremity. Anatomically, this variation was characterized by the absence of
the brachiocephalic trunk, with four separate arteries arising directly from the aortic arch. While the ARSA itself may
not have been directly responsible for the patient’s cause of death, its potential clinical relevance warrants consideration.
The aberrant artery is often associated with complications, such as dysphagia, recurrent respiratory infections, and
challenges in vascular interventions. Additionally, its propensity for dilatation—particularly at the junction with the
aortic arch—can lead to compression of nearby structures, contributing to symptoms such as dysphagia lusoria and
impaired clearance of bronchial secretions. This case underscores the importance of thorough anatomical examination
and an enhanced awareness of vascular variations, which are crucial for both clinical management and educational
purposes. The discovery of such an anatomical anomaly emphasizes the significance of cadaveric studies in advancing
medical education and further highlights the need for comprehensive clinical understanding of rare vascular variants.
Objective: This report describes a rare cadaveric finding of an aberrant right subclavian artery (ARSA) discovered during
a routine dissection in a first-year medical anatomy course.
Case Description: During a cadaver dissection session, an 88-year-old female cadaver was found to have an ARSA.
The anomaly was characterized by the absence of the brachiocephalic trunk and the presence of four separate arteries
originating directly from the aortic arch. The ARSA originated as the last branch of the aortic arch, distal to the left
subclavian artery, and coursed posterior to the esophagus and trachea before reaching the right upper extremity.
Conclusion: The discovery of an ARSA highlights the importance of thorough anatomical examination and awareness of
potential variations. This anatomical variant has significant clinical implications, including potential dysphagia, surgical
considerations, and association with other congenital anomalies.
