Highlights
- •Congenital aortic arch anomalies and variants are common findings on MRA neck examinations.
- •Proper identification is important for potential surgical and percutaneous interventions.
- •A review of embryology can help us to better understand the development of congenital arch anomalies and variants.
- •With an understanding of embryologic pathways, even exceedingly rare and complicated anomalies can be explained.
Abstract
Introduction
Congenital aortic arch anomalies and variants have been extensively characterized
in the medical literature. Proper identification of these anomalies is important when
surgical or percutaneous interventions are indicated.
Case presentation
We present a case of a 48-year old male who presented to the emergency department
with altered mental status. Magnetic resonance angiography (MRA) findings revealed
an aberrant right subclavian artery (ARSA), early bifurcation of the right common
carotid artery (CCA) with anomalous origin of the right vertebral artery (VA) from
the right common carotid artery bifurcation, anomalous left vertebral artery originating
from the aortic arch, and absent left common carotid artery with independent origins
of the left external carotid artery (ECA) and internal carotid artery (ICA). No other
abnormalities were identified, and the patient demonstrated no symptoms attributable
to his vascular anomalies.
Conclusion
To our knowledge, this unique combination of anomalies has never been reported in
the literature. With an understanding of embryological pathways, even exceedingly
rare anomalies like this one can be explained.
Keywords
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Article info
Publication history
Published online: January 21, 2022
Accepted:
January 10,
2022
Received in revised form:
January 7,
2022
Received:
October 25,
2021
Identification
Copyright
© 2022 Elsevier Inc. All rights reserved.
