PMC5852896_01
Sequential CT scan images show origin of right subclavian artery from the proximal descending thoracic aorta ((a), black arrow) and coursing posterior to the esophagus ((b), black arrow).
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fig1
The sternotomy was closed and a CT of the chest was performed, which demonstrated the anomalous right subclavian artery without aneurysmal degeneration (Figures 1(a) and 1(b)).
(a) Intraoperative angiogram performed in an AP projection through a sheath positioned in the right axillary artery from a right brachial approach. The right subclavian artery is seen (wide arrow) as is the left subclavian artery (narrow arrow). (b) Intraoperative image in the same projection after deployment of a balloon expandable covered stent at level of esophageal-arterial communication. The arrow indicates the position of the covered stent.
CRIVAM2018-7541904.002.jpg
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fig2
An angiogram was performed (Figure 2(a)) and three covered stents were deployed to span the artery-esophageal fistula via a right brachial artery approach (Figure 2(b)).