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Nedelcu AH, Lupu A, Moraru MC, Tarniceriu CC, Stan CI, Partene Vicoleanu SA, Haliciu AM, Statescu G, Ursaru M, Danielescu C, Ioniuc I, Tepordei RT, Lupu VV. Morphological Aspects of the Aberrant Right Subclavian Artery-A Systematic Review of the Literature. J Pers Med 2024; 14:335. [PMID: 38672962 PMCID: PMC11051064 DOI: 10.3390/jpm14040335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Revised: 03/09/2024] [Accepted: 03/21/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND The aberrant origin of the right subclavian artery (ARSA), also known as the lusoria artery, is a congenital malformation with an incidence of 0.5-4.4%. Most cases are incidental due to minimal clinical manifestations. Computer tomography (CT) is important in diagnosing and evaluating these patients. MATERIALS AND METHODS We conduct a computerized search in two databases, PubMed and EMBASE, for articles published between 1 January 2022 and 31 December 2023, PROSPERO code: CRD42024511791. Eligible for inclusion were case reports and case series that presented the aberrant origin of the right subclavian artery. The main outcome was the highlighting of the morphological types of ARSA. In this context, we proposed a new classification system of this anomaly. The secondary outcome was the evaluation of the demographic distribution of the lusoria artery. RESULTS Our search identified 47 articles describing 51 patients with ARSA. The typical course for ARSA is retroesophageal, being registered in 49 out of 51 patients. This malformation is frequently associated with Kommerell diverticulum (15 out of 51), troncus bicaroticus (7 out of 51), and aberrant origins of the right vertebral artery (7 out of 51). We observed a higher incidence of the condition among women (32 out of 51) compared to men (19 out of 51). From a demographic point of view, ARSA is more frequent in the "44 to 57 years" and "58 to 71 years" age ranges. CONCLUSIONS ARSA is a congenital malformation resulting from a defect in the development of the aortic arches. The imaging studies such as computer tomography play a defined diagnostic role.
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Affiliation(s)
- Alin Horatiu Nedelcu
- Department of Morpho-Functional Science I, Discipline of Anatomy, “Grigore T. Popa” University of Medicine and Pharmacy, 16 Universitatii Street, 700115 Iasi, Romania; (A.H.N.); (C.C.T.); (C.I.S.); (S.A.P.V.); (A.M.H.); (G.S.); (R.T.T.)
- Radiology Clinic, Recovery Hospital, 700661 Iasi, Romania
| | - Ancuta Lupu
- Department of Mother and Child, “Grigore T. Popa” University of Medicine and Pharmacy, 16 Universitatii Street, 700115 Iasi, Romania; (I.I.); (V.V.L.)
| | - Marius Constantin Moraru
- Department of Morpho-Functional Science I, Discipline of Anatomy, “Grigore T. Popa” University of Medicine and Pharmacy, 16 Universitatii Street, 700115 Iasi, Romania; (A.H.N.); (C.C.T.); (C.I.S.); (S.A.P.V.); (A.M.H.); (G.S.); (R.T.T.)
| | - Cristina Claudia Tarniceriu
- Department of Morpho-Functional Science I, Discipline of Anatomy, “Grigore T. Popa” University of Medicine and Pharmacy, 16 Universitatii Street, 700115 Iasi, Romania; (A.H.N.); (C.C.T.); (C.I.S.); (S.A.P.V.); (A.M.H.); (G.S.); (R.T.T.)
| | - Cristinel Ionel Stan
- Department of Morpho-Functional Science I, Discipline of Anatomy, “Grigore T. Popa” University of Medicine and Pharmacy, 16 Universitatii Street, 700115 Iasi, Romania; (A.H.N.); (C.C.T.); (C.I.S.); (S.A.P.V.); (A.M.H.); (G.S.); (R.T.T.)
| | - Simona Alice Partene Vicoleanu
- Department of Morpho-Functional Science I, Discipline of Anatomy, “Grigore T. Popa” University of Medicine and Pharmacy, 16 Universitatii Street, 700115 Iasi, Romania; (A.H.N.); (C.C.T.); (C.I.S.); (S.A.P.V.); (A.M.H.); (G.S.); (R.T.T.)
| | - Ana Maria Haliciu
- Department of Morpho-Functional Science I, Discipline of Anatomy, “Grigore T. Popa” University of Medicine and Pharmacy, 16 Universitatii Street, 700115 Iasi, Romania; (A.H.N.); (C.C.T.); (C.I.S.); (S.A.P.V.); (A.M.H.); (G.S.); (R.T.T.)
| | - Gabriel Statescu
- Department of Morpho-Functional Science I, Discipline of Anatomy, “Grigore T. Popa” University of Medicine and Pharmacy, 16 Universitatii Street, 700115 Iasi, Romania; (A.H.N.); (C.C.T.); (C.I.S.); (S.A.P.V.); (A.M.H.); (G.S.); (R.T.T.)
| | - Manuela Ursaru
- Department of Surgical Sciences I, “Grigore T. Popa” University of Medicine and Pharmacy, 16 Universitatii Street, 700115 Iasi, Romania; (M.U.); (C.D.)
- Radiology Clinic, “Sf Spiridon” County Clinical Emergency Hospital Iasi, 700661 Iasi, Romania
| | - Ciprian Danielescu
- Department of Surgical Sciences I, “Grigore T. Popa” University of Medicine and Pharmacy, 16 Universitatii Street, 700115 Iasi, Romania; (M.U.); (C.D.)
| | - Ileana Ioniuc
- Department of Mother and Child, “Grigore T. Popa” University of Medicine and Pharmacy, 16 Universitatii Street, 700115 Iasi, Romania; (I.I.); (V.V.L.)
| | - Razvan Tudor Tepordei
- Department of Morpho-Functional Science I, Discipline of Anatomy, “Grigore T. Popa” University of Medicine and Pharmacy, 16 Universitatii Street, 700115 Iasi, Romania; (A.H.N.); (C.C.T.); (C.I.S.); (S.A.P.V.); (A.M.H.); (G.S.); (R.T.T.)
| | - Vasile Valeriu Lupu
- Department of Mother and Child, “Grigore T. Popa” University of Medicine and Pharmacy, 16 Universitatii Street, 700115 Iasi, Romania; (I.I.); (V.V.L.)
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Arhire DA, Moraru MC, Maxim R, Tarniceriu CC, Partene Vicoleanu SA, Haisan A, Nedelcu I, Nedelcu AH. Transient hepatic attenuation difference (THAD) or fat sparing? Aberrant right gastric vein (ARGV) determining a pseudolesion at the border of the IInd/IIIrd liver segments. Review of developmental concepts. Folia Morphol (Warsz) 2023:VM/OJS/J/96455. [PMID: 37691513 DOI: 10.5603/fm.96455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 08/27/2023] [Accepted: 08/28/2023] [Indexed: 09/12/2023]
Abstract
The aberrant right gastric vein (ARGV) is a rare anatomical variation. It can be responsible for unexplained hyperdensities in the hepatic parenchyma on CT scans, also known as third inflow effects. We present two cases sharing similar vascular pattern and slightly different imagistic findings on ultrasound and computer-tomography performed studies. Both ultrasonographies showed a nodular-geographic hypoechoic area within a hyperechogenic fatty liver. Further CT evaluation showed in both cases a hyperattenuating homogenous area clearly visible on all four phases at the border of the IInd/IIIrd hepatic segment, that enhance especially on the portal venous phase, with no slow-fill, wash-out, central scar or rim-like features. The areas were considered to be focal fat sparing areas in diffuse fatty liver or a perfusion disorder due to the presence of an aberrant right gastric vein. The aim of this paper is to discuss the embryological aspects which are the groundwork for this vascular anomaly and to correlate the findings with imagistic aspects. These two ARGV produced pseudolesions, understood as focal fat sparing areas within diffuse fatty livers. These pseudolesions mimic liver tumours, therefore it is important to look for such an aberrant vessel in order to rule out other diagnoses.
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Affiliation(s)
- Dan Alexandru Arhire
- Radiology Clinic, Sf. Spiridon County Clinical Emergency Hospital, Iasi, Romania.
- Arhimed Radiology, Hatman Sendrea No. 2, Iasi, Romania.
| | - Marius Constantin Moraru
- Department of Morpho-Functional Science I, Discipline of Anatomy, "Grigore T. Popa" University of Medicine and Pharmacy, Iasi, Romania
| | - Razvan Maxim
- Department of Morpho-Functional Science I, Discipline of Anatomy, "Grigore T. Popa" University of Medicine and Pharmacy, Iasi, Romania
| | - Claudia Cristina Tarniceriu
- Department of Morpho-Functional Science I, Discipline of Anatomy, "Grigore T. Popa" University of Medicine and Pharmacy, Iasi, Romania
| | - Simona Alice Partene Vicoleanu
- Department of Morpho-Functional Science I, Discipline of Anatomy, "Grigore T. Popa" University of Medicine and Pharmacy, Iasi, Romania
| | - Anca Haisan
- Emergency Department, Sf. Spiridon County Clinical Emergency Hospital, Iasi, Romania
- Department of Emergency Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, Iasi, Romania
| | - Irina Nedelcu
- ENT Department, Sf. Spiridon County Clinical Emergency Hospital, Iasi, Romania
| | - Alin Horatiu Nedelcu
- Radiology Clinic, Recovery Hospital, Iasi, Romania
- Department of Morpho-Functional Science I, Discipline of Anatomy, "Grigore T. Popa" University of Medicine and Pharmacy, Iasi, Romania
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