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Acquired diseases of aberrant subclavian arteries
S Mulligan1, P H Nath, F S Keller
1Department of Radiology, University of Alabama, Birmingham, School of Medicine.
Insights
Aberrant subclavian arteries (ASAs) can develop acquired diseases like aneurysms and dissections. Atherosclerosis due to abnormal blood flow turbulence around ASAs may cause these complications.
Area of Science:
- Vascular Surgery
- Radiology
- Cardiovascular Medicine
Background:
- Aberrant subclavian arteries (ASAs) are congenital anomalies with known anatomic, clinical, and radiologic features.
- Acquired diseases, including aneurysms, dissections, and stenosis, can complicate ASAs.
- The underlying mechanism for these acquired complications is not fully understood.
Observation:
- This study investigated acquired diseases affecting ASAs and adjacent aortas in six patients.
- Computed tomographic and angiographic measurements were compared in adults with and without arch anomalies.
- Angiographic measurements of ASAs in children were also analyzed.
Findings:
- ASAs were found to dilate in older patients.
- Two patients presented with aneurysms, two with aortic dissections, and two with stenosis of ASAs or adjacent aorta.
- Abnormal turbulence around the ASA is proposed as a cause of atherosclerosis, leading to these acquired complications.
Implications:
- Radiologists must recognize the significance of ASAs in patients presenting with aortic aneurysms and dissections.
- Awareness of ASA-related complications is crucial for accurate radiologic diagnosis.
- Clinical management strategies should consider the potential for acquired diseases in patients with ASAs.
Abstract:
The anatomic, clinical, and radiologic findings of aberrant subclavian arteries (ASAs) are well known. Acquired diseases such as aneurysms, dissections, or stenosis can complicate these anomalies. We propose that these complications are a result of atherosclerosis caused by abnormal turbulence around the ASA. Comparisons of computed tomographic and angiographic measurements of subclavian arteries in adults with and without arch anomalies and angiographic measurements of ASAs in children show that ASAs dilate in older patients. We describe six patients with acquired diseases of ASAs or the aorta adjacent to the ASA. Aneurysms, aortic dissections, and stenosis were each found in two patients. Problems in the radiologic diagnosis and clinical management of these diseases are emphasized. Radiologists should be cognizant of the significance of ASAs in patients with aortic aneurysms and dissections.