Magnetic resonance angiography diagnosis of late-onset dysphagia due to arteria lusoria

Anatomic variations of the great vessels, particularly involving the subclavian artery, are important to recognize due to their potential impact on surgical, endovascular, and diagnostic procedures. [1,2]Arteria lusoria is the most common aortic arch anomaly also known as aberrant right subclavian artery in a pathology where brachiocephalic trunk is absent and four large arteries arise from the arch of the aorta: the right common carotid artery (CCA), the left CCA, the left subclavian artery, and the final one with the most distal left-sided origin, the right subclavian artery.This vessel travels to the right arm, crossing the middle line of the body and usually passing behind the esophagus.If the artery compresses the esophagus, it may produce a condition called dysphagia lusoria.The incidence is reported to be 0.2 to 1.7% in population.Frequently, the arteria lusoria arises from an aortic arch diverticulum at the proximal descending aorta, first described by Kommerell. [3] this report, we present a rare case of an anomalous right subclavian artery originating posteriorly from the aortic arch with accompanying vascular stenosis diagnosed in an adult.A 67-year-old male patient was hospitalized and intubated by the anesthesia team with preliminary diagnoses of respiratory distress and general condition deterioration and pneumonia.His past medical history was unremarkable, and there was no history of trauma or significant cardiovascular events.Subsequently, a magnetic resonance imaging (MRI) was performed, which revealed an anomaly of the right subclavian artery and aorta.A contrast-enhanced magnetic resonance (MR) angiography was, then, conducted to confirm the diagnosis.Although the MRI images