Novel right-angled origin and severe tortuosity of the right subclavian artery: a previously unrecognized challenge in transradial access.

BACKGROUND

The right subclavian artery typically originates from the lateral wall of the brachiocephalic trunk without tortuosity. Its anatomical variations pose significant challenges during transradial access. Although variations of the right subclavian artery are well-documented, no study has reported a variation in its origin angle.

MATERIALS AND

METHODS

We report an exceptionally rare dual variation identified during dissection and discuss the clinical significance of this novel variation, emphasizing the technical challenges it poses during transradial access.

RESULTS

The right subclavian artery demonstrated a right-angled origin from the posterior wall of the brachiocephalic trunk, in contrast to the normal lateral wall origin, accompanied by severe tortuosity.

CONCLUSIONS

To our knowledge, this is the first documented case of the right subclavian artery origin angle variation. This variation may reduce transradial access success rates and increase the risks of procedural complications and mortality. The finding expands the known spectrum of the right subclavian artery anatomical variations and identifies a previously unrecognized challenge in transradial access.