Multidetector CT Scan Findings of a Right Aberrant Retroesophageal Vertebral Artery With an Anomalous Origin From a Cervical Aortic Arch

Various malformations of the aortic arch and great vessels have been reported in the literature, which reflects the complexity of their embryologic development. Most of them are of incidental finding and remain asymptomatic but can be responsible for respiratory or digestive symptoms and be associated with congenital cardiac diseases. We report the ease of a patient presenting a right retroesophageal vertebral artery. This malformation was associated with multiple anomalies of the aortic arch. We report a classification of the most common aortic arch abnormalities by recalling Edwards double aortic arch model and embryologic variants. Here, we report on the rare case of a right retroesophageal vertebral artery. We assimilate this malformation to a vertebral arteria lusoria and attribute it to the lack of caudal migration of the fourth branchial arch, responsible for a left cervical aortic arch with an interruption between the right subclavian and vertebral arteries. CHEST 2010;138(2):418-422