Anomalous Right Subclavian Artery-Esophageal Fistulae. (1st March 2018)

• Record Type: Journal Article
• Authors: Shires, Courtney Brooke; Rohrer, Michael J.
• Other Names: Sindel Muzaffer Academic Editor.
• Is Part Of: Case reports in vascular medicine. Volume 2018(2018)
• Publication Date: 2018-03-01
• Subjects: Peripheral vascular diseases -- Periodicals; 616.13005
• DOI: 10.1155/2018/7541904
• Languages: English
• ISSNs: 2090-6986

Abstract

Abstract : An aberrant right subclavian artery (ARSA) is the most common aortic arch anomaly, but only 19 previous cases of ARSA-esophageal fistula have been reported. Six patients have survived their bleeding episode. We describe the case of a 44-year-old woman who developed massive hemoptysis. Laryngoscopy, bronchoscopy, head and neck angiogram, and median sternotomy did not reveal what was presumed initially to be a tracheoinnominate fistula. Contrasted CT showed an anomalous subclavian artery posterior to the esophagus. Given the technical challenge of approaches for this pathology, the patient was unfit for open surgical repair. Therefore, endovascular covered stent grafts were deployed spanning the segment of the subclavian artery in continuity with the esophagus, via a right brachial artery approach. Unfortunately, the patient died after successful placement of the grafts.