Artery, Subclavian

The right subclavian artery usually shares a common origin with the right CCA called the brachiocephalic artery. However, it could originate directly from the aortic arch and be called lusorian artery (Case 1).

Pre-vertebral subclavian artery stenosis/occlusion can cause subclavian artery steal syndrome (Case 2).


1 Aberrant Right Subclavian Artery


CTA Neck

The aberrant right subclavian artery/lusorian artery (red arrow) which can be easily ascertained on CTA neck, is considered a relative contraindication for radial access.[1] Yellow arrow: right CCA. Blue arrow: left CCA. Green arrow: left subclavian artery. Orange arrow: right VA. Pink star: esophagus. White diamond: trachea. (Unfortunately, this is not an ideal study due to the suboptimal timing and contrast contamination in the adjacent veins.)


CTA Chest

This patient presented after a chest trauma. There is also an aberrant right subclavian artery (red arrow). Also, please note the right pulmonary contusion and the chest tube.


This is an MRA neck of another patient who has an aberrant right subclavian artery.



An interesting observation from the 3D reconstruction of this aberrant right subclavian artery from the CTA is that the right VA originates from the right CCA (white arrow).

2 Left Subclavian Artery Origin Occlusion


This patient was noticed to have discrepancy of the blood pressures on bilateral upper extremities. Intra-operative left subclavian artery and right vertebral artery angiographies revealed pre-vertebral occlusion of the left subclavian artery.

Occluded left subclavian artery with retrograde contrast flow into the aorta and left common carotid artery (arrow).

Right vertebral artery run in the same patient showed retrograde flow into the left vertebral artery and left subclavian artery. Notice there is also absence of bilateral posterior cerebral arteries due to bilateral fetal posterior communicating arteries.


This fluoroscopy demonstrated an occluded left subclavian artery origin (red arrow).

Right VA injection showed retrograde flow into the left VA.

  1. Radial Access via Aberrant Right Subclavian Artery | ↩︎