Transbrachial stenting of a critical ostial arteria lusoria stenosis.

PURPOSE: To report the endovascular treatment of a critical ostial stenosis in an aberrant right subclavian artery (ARSA), a rare embryologic anomaly of the aortic arch.

CASE REPORT: A 76-year-old woman presented with acute ischemia of her right forearm. Her medical history was notable for hyperlipidemia but otherwise negative for risk factors of atherosclerosis. Color-coded duplex ultrasonography revealed occlusion of the distal brachial and cubital artery, poststenotic flow in the distal subclavian and axillary artery, and reversal of flow in the right vertebral artery. The patient underwent contrast-enhanced multidetector computed tomography of the thorax, which revealed the presence of an ARSA with a calcified, high-grade ostial stenosis. The lesion was successfully stented via a brachial access.

CONCLUSIONS

Endovascular treatment of an ostial stenosis in an aberrant right subclavian artery is feasible by means of transbrachial approach.