Vertebral arteria lusoria is an extremely rare anatomical variant of the aortic arch, whereby the right vertebral artery arises from the aorta distal to the left subclavian artery 1. The aberrant right vertebral artery has a retro-esophageal and retrotracheal course before entering a cervical transverse foramen 2.
Right vertebral arteria lusoria can also present with a Kommerell's diverticulum and/or a bovine arch 1. An increased association with other vascular anatomic variants, aneurysms, dissection, and other vascular-related pathologies is suspected 3.
Clinical presentation
While typically discovered incidentally and without symptoms, the presence of certain manifestations such as headache, dizziness, and/or dysphagia is rare 3. Dysphagia lusoria specifically refers to cases where dysphagia is present and can be directly linked to an anomalous retro-esophageal artery, often the aberrant right subclavian artery 2.
Treatment and prognosis
Although this variant generally does not exhibit symptoms and does not necessitate treatment, it is crucial to identify it before surgical procedures and prior to angiographic or endoscopic interventions. This pre-operative identification is essential to prevent iatrogenic injuries 2,3.
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