What are the other Names for this Condition? (Also known as/Synonyms)

• Aberrant Left Subclavian Artery
• Aberrant Right Subclavian Artery
• Diverticulum of Kommerell 

What is Aberrant Subclavian Artery? (Definition/Background Information)

• Aberrant Subclavian Artery (ASA) is a rare congenital vascular anomaly where the subclavian artery arises abnormally from the aortic arch. It is often asymptomatic and is typically discovered incidentally during imaging studies, but in some cases, it can cause symptoms like swallowing difficulties or breathing issues.
• Aberrant Subclavian Artery is present from birth and affects approximately 1% of individuals. It occurs equally in both sexes and is typically discovered in childhood or adulthood, often during evaluation for other conditions or symptoms like dysphagia.
• Currently, no specific risk factors have been identified for Aberrant Subclavian Artery. The anomaly is believed to result from an abnormality in the development of the aortic arch during embryogenesis. Genetic and environmental factors may play a role in its occurrence, but further research is needed.
• Aberrant Subclavian Artery is caused by abnormal remodeling of the aortic arch during embryonic development. Instead of the right subclavian artery arising in its normal position, it originates from a different part of the aorta, leading to its aberrant course. This process is believed to be due to genetic and developmental factors.
• While most individuals with Aberrant Subclavian Artery are asymptomatic, some may experience symptoms such as difficulty swallowing (dysphagia lusoria), respiratory infections, wheezing, chest pain, and in rare cases, nerve compression symptoms such as voice changes or breathing difficulty.
• Aberrant Subclavian Artery is usually diagnosed incidentally during imaging studies such as barium swallow, echocardiogram, or CT/MRI scans. In symptomatic cases, further vascular imaging may be used to assess the structure of the aberrant artery and its impact on surrounding tissues.
• Complications of Aberrant Subclavian Artery may include difficulty breathing, recurrent respiratory infections, weight loss, voice defects, and in rare cases, aneurysm formation and rupture. If left untreated in symptomatic cases, these complications can lead to more serious health issues, including nerve damage and chronic tissue damage.
• Asymptomatic cases typically require no treatment. For individuals with significant symptoms, surgical correction of the aberrant artery is the primary treatment option. The goal of surgery is to relieve pressure on surrounding structures like the esophagus and trachea.
• There are currently no known methods to prevent the development of Aberrant Subclavian Artery, as it is a congenital condition resulting from anomalies during fetal development. Early detection and management of symptoms are key in reducing the risk of complications.
• The prognosis for individuals with Aberrant Subclavian Artery is generally good, especially in asymptomatic cases where no treatment is needed. In cases where surgery is required, most patients experience significant relief from symptoms and have a favorable outcome with proper management.

Who gets Aberrant Subclavian Artery? (Age and Sex Distribution)

• Aberrant Subclavian Artery (ASA) is a congenital anomaly, meaning it is present from birth.
• It affects both males and females equally and can be found in individuals of all ages.
• Worldwide, individuals of all racial and ethnic groups may be affected

Though the condition is often detected in adulthood during imaging studies for unrelated health issues, it can also be identified in children, particularly if they present with symptoms like feeding difficulties or recurrent respiratory infections.

What are the Risk Factors for Aberrant Subclavian Artery? (Predisposing Factors)

Currently, no specific risk factors have been identified for Aberrant Subclavian Artery. Since it is a congenital condition, the anomaly likely occurs due to factors affecting embryonic development.

• Genetic and environmental influences may play a role, though no clear associations have been established.
• There is no known familial predisposition or hereditary pattern associated with this vascular anomaly.

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one’s chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Aberrant Subclavian Artery? (Etiology)

• Aberrant Subclavian Artery is caused by an abnormality in the embryonic development of the aortic arch.
• During this process, parts of the aortic arch, which typically regress or develop in a coordinated manner, fail to do so correctly. This leads to the abnormal positioning of the subclavian artery.

While the exact cause remains unknown, both genetic and environmental factors may contribute to this vascular anomaly during fetal development.

What are the Signs and Symptoms of Aberrant Subclavian Artery?

• The signs and symptoms of Aberrant Subclavian Artery vary widely. Many individuals remain asymptomatic, with the condition often discovered incidentally.
• However, in symptomatic cases, individuals may experience swallowing difficulties (dysphagia), recurrent respiratory infections, wheezing, chest pain, and difficulty breathing.
• Severe cases can lead to complications such as dysphagia lusoria (difficulty swallowing due to esophageal compression), and in rare instances, nerve compression causing voice defects or aneurysm formation.

How is Aberrant Subclavian Artery Diagnosed?

• Aberrant Subclavian Artery is typically diagnosed incidentally during imaging studies conducted for unrelated reasons.
• Common diagnostic tools include a barium swallow, echocardiogram, CT angiography, or MRI, which can reveal the aberrant artery’s abnormal course.
• In symptomatic cases, these imaging studies are used to assess the vascular anomaly and determine if it is contributing to issues such as esophageal or tracheal compression.

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Aberrant Subclavian Artery?

The complications of Aberrant Subclavian Artery may include:

• Weight loss due to compression of esophagus (food pipe) causing dysphagia lusoria
• Difficulty breathing and frequent lung infections (due to compression of trachea)
• Voice defects due to compression of nerves in the recurrent laryngeal nerve (Ortner’s syndrome)
• Rupture of aneurysm

Complications may occur with or without treatment, and in some cases, due to treatment also.

How is Aberrant Subclavian Artery Treated?

Treatment for Aberrant Subclavian Artery depends on the presence and severity of symptoms. Asymptomatic cases generally do not require any treatment.

• However, if the condition causes significant symptoms like dysphagia or breathing difficulties, surgical intervention may be necessary.
• Surgery typically involves revascularization or rerouting the aberrant artery to relieve the compression on the esophagus or trachea.

Post-surgical monitoring ensures successful outcomes.

How can Aberrant Subclavian Artery be Prevented?

• Aberrant Subclavian Artery is a congenital condition, meaning it develops during fetal development and cannot be prevented.
• There are no known methods to avoid the anomaly since its exact cause is still unclear and believed to be related to abnormal embryonic development.

However, managing risk factors for vascular anomalies during pregnancy, such as ensuring proper prenatal care, may help improve overall fetal health.

What is the Prognosis of Aberrant Subclavian Artery? (Outcomes/Resolutions)

The prognosis of Aberrant Subclavian Artery depends on whether symptoms are present.

• In most cases, the condition is asymptomatic and may not require any treatment, allowing individuals to live normal, healthy lives without complications.
• For those with symptomatic cases, such as dysphagia or breathing difficulties, surgery can alleviate symptoms and improve quality of life.

With successful treatment, the prognosis is generally favorable. However, in rare cases where complications like aneurysms occur, the outcome may depend on the severity and timely management of those complications.

Additional and Relevant Useful Information for Aberrant Subclavian Artery:

• Aberrant Subclavian Artery is also known by the following additional synonym: Lusorian Artery

The following DoveMed website link is a useful resource for additional information:

http://www.dovemed.com/diseases-conditions/rare-disorders/