Complications of anomalous origin of the right subclavian artery: case report and review of the literature.
A 35-year-old black woman presented with thrombosis of an anomalous right subclavian artery and distal arterial embolization. Initially, her right subclavian artery was reimplanted onto the common carotid artery, and a brachial artery embolectomy plus intraoperative thrombolytic therapy were used to reopen her distal arterial circulation. When her brachial artery repair thrombosed the following day, a distal ulnar artery bypass and repeat thrombolytic therapy were required to restore arterial patency. Six months later, she returned with severe, progressive, neointimal hyperplasia of her brachial artery and a second attempt at arterial reconstruction was unsuccessful. She eventually required a right below-elbow amputation. This patient demonstrated an anomalous right subclavian artery that presented with distal embolization without an antecedent history of severe atherosclerotic disease or the development of a right subclavian artery aneurysm. A review of the medical literature relating to complications of this anomaly is provided.
Akers
D L
DL
Department of Surgery, University of Cincinnati Medical Center, Ohio 45267-0558.
Fowl
R J
RJ
Plettner
J
J
Kempczinski
R F
RF
D000328:Adult; D001916:Brachial Artery / Q000000981:diagnostic imaging; D004617:Embolism / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D005260:Female; D006801:Humans; D011859:Radiography; D013348:Subclavian Artery / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000601:surgery; D013927:Thrombosis / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery