Aberrant Right Subclavian Artery and Stanford Type B Aortic Dissection

An aberrant right subclavian artery (ARSA) is a rare developmental anomaly (0.4-1.8%)of the aorta in which the right subclavian artery arises from the aortic arch distal to the origin of the left subclavian artery often coursing behind the esophagus to reach the right arm. It courses behind the esophagus in about 80% of cases, between the esophagus and the trachea in 15%, and anterior to the trachea or mainstem bronchus in 5%. Patient with this anomaly rarely have symptoms (90-95%) but when symptomatic the ARSA give rise to symptoms of dysphagia lusoria, dyspnea and chronic cough. In a vast majority of patients ARSA is clinically silent till right radial angiography is performed. We are reporting a case of dissection of the retroesophageal right subclavian artery with extension to the descending thoracic aorta (Stanford Type B).