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Case Reports
. 2025 Feb 23;17(2):e79527.
doi: 10.7759/cureus.79527. eCollection 2025 Feb.

An Aberrant Right Subclavian Artery Causing Severe Esophageal Compression: A Case Report

Nektarios Galanis  1 , Dimosthenis Chrysikos  1 , Michail Palaios  1 , Ameer Shehade  1 , Panagiotis Georgakopoulos  1 , Dimitrios Patsouras  1 , Theodore Troupis  1
Affiliations
Case Reports

An Aberrant Right Subclavian Artery Causing Severe Esophageal Compression: A Case Report

Nektarios Galanis et al. Cureus. .

Abstract

An aberrant right subclavian artery (ARSA), a congenital vascular anomaly, can cause significant esophageal compression, leading to a condition known as dysphagia lusoria (DL). We present the case of a 44-year-old man with progressively worsening dysphagia and odynophagia over the last six months, resulting in severe weight loss and dietary restrictions. Imaging techniques revealed esophageal stenosis caused by external compression from an ARSA arising from the posterior wall of the distal aortic arch, accompanied by a Kommerell's diverticulum. Computed tomography angiography confirmed the aberrant origin, retroesophageal course, and vascular anomaly. Although surgical intervention involving ligation and excision of the retroesophageal artery segment with a right carotid-subclavian bypass was recommended, the patient opted for conservative management. This case highlights the importance of advanced imaging techniques in diagnosing DL and guiding treatment decisions. Regular follow-up remains essential to monitor disease progression and manage potential complications.

Keywords: aberrant right subclavian artery; dysphagia lusoria; esophageal compression; kommerell’s diverticulum; vascular anomalies.

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Conflict of interest statement

Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Esophagography demonstrating esophageal stenosis (red arrow).
Figure 2
Figure 2. CT angiography: horizontal section at the level of the third thoracic vertebra. The RCCA, LCCA, and LSA are identified. The RSA is seen ventral to the third vertebral body, causing significant compression of the esophagus.
CT: computed tomography; RCCA, right common carotid artery; LCCA, left common carotid artery; E: esophagus; LSA: left subclavian artery; RSA: right subclavian artery.
Figure 3
Figure 3. CT angiography: coronal section of the thorax at the level of the esophagus. The ascending course of the RSA from the left to the right is visualized, originating from the posterior wall of the distal aortic arch. Note the slight enlargement at the origin of the RSA.
CT: computed tomography; E: esophagus; RSA, right subclavian artery.
Figure 4
Figure 4. Computed tomography (CT) angiography of the upper thorax with 30-mm thick slabs: (A) Coronal section rotated 45º to the right of the vertical axis. (B) Horizontal section at the level of the third thoracic vertebra. (C) Coronal section rotated 55º to the left of the vertical axis.
CT: computed tomography; LSA: left subclavian artery; RSA: right subclavian artery; E: esophagus; RCCA: right common carotid artery; LCCA: left common carotid artery.
See this image and copyright information in PMC

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