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Aberrant Right Subclavian Artery: Demographics, Morphological Features and Follow up CT Scans Dynamics
Maysam Shehab1, Stanislav Kosykh2, Ammie Wolf1
1Vascular Surgery Department, Meir Medical Center, Faculty of Medicine, Tel Aviv University, Kfar Saba, Israel.
Vascular and Endovascular Surgery
|September 28, 2023
Summary
Aberrant right subclavian artery (ARSA) shows a benign natural history with slow growth rates. Further research is needed to establish standardized imaging follow-up protocols for asymptomatic cases.
Area of Science:
- Cardiovascular Imaging
- Vascular Surgery
- Radiology
Background:
- Aberrant right subclavian artery (ARSA) is the most common aortic arch anomaly, affecting 0.5-1% of the population.
- A standardized follow-up protocol for ARSA, particularly in asymptomatic individuals, is lacking.
- Understanding the natural history of ARSA is crucial for clinical management.
Purpose of the Study:
- To evaluate the natural history of aberrant right subclavian artery (ARSA).
- To assess the role and effectiveness of serial computed tomography (CT) scans in monitoring ARSA.
- To analyze morphological changes in ARSA over time using CT imaging.
Main Methods:
- Retrospective single-center study of patients with ARSA diagnosed via chest CT scans (February 2013 - July 2022).
- Collection of patient medical records and CT scan data, including aortic and ARSA measurements.
- Morphological analysis of ARSA and aorta dimensions on initial and follow-up CT scans.
Main Results:
- The study included 65 patients (70.8% women, average age 58.5 years) with a median follow-up of 4 years.
- Kaplan-Meier survival estimates at 1 and 5 years post-diagnosis were 97% and 93%, respectively.
- Nineteen patients showed a statistically significant, albeit small, increase in ARSA diameter (mean 16.91 mm vs 16.31 mm) between scans (P=0.04).
Conclusions:
- The cohort exhibits a benign natural history for ARSA, characterized by slow growth rates.
- The small sample size precludes definitive recommendations for imaging follow-up protocols.
- Larger cohorts and extended follow-up intervals are necessary to establish clinical guidelines for ARSA management.
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