Eur J Cardiothorac Surg 2002;21:927
© 2002 Elsevier Science NL
Images in cardio-thoracic surgery |
Unsuspected vascular anomaly at cervical mediastinoscopy
Rizwan A. Qureshia,
Amanda L. Holgatea,
Judith M. Harringtonb,
Richard G. Berrisforda*
a Department of Thoracic Surgery, Royal Devon & Exeter NHS Trust, Barrack Road, Exeter, Devon, EX2 5DW, UK
b Department of Radiology, Royal Devon & Exeter NHS Trust, Exeter, Devon, UK
Received 7 January 2002;
received in revised form 14 February 2002;
accepted 18 February 2002.
* Corresponding author. Tel.: +44-1392-402689; fax: +44-1392-402175
e-mail: richard.berrisford{at}rdehc-tr.swest.nhs.uk
Key Words: Aberrant right common carotid artery • Magnetic resonance arteriogram • Cervical mediastinoscopy • Morbidity
Blunt dissection during cervical mediastinoscopy revealed an aberrant right common carotid artery traversing the front of the trachea, just below the isthmus of the thyroid gland. Magnetic resonance arteriogram (MRA) is shown in Fig. 1
with a schematic diagram in Fig. 2
. We highlight this vascular anomaly (prevalence 0.5%) which can jeopardize the safety of cervical mediastinoscopy.
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Fig. 1. MRA showing common carotid trunk arising anteriorly with both subclavian origins more posteriorly. AA, aortic arch; CCT, common carotid trunk; RCA, right common carotid artery; LCA, left common carotid artery; RSA, right subclavian artery; LSA, left subclavian artery.
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Fig. 2. Schematic diagram based on Fig. 1 showing the aberrant right common carotid artery passing almost horizontally across the superior mediastinum just above the level of a high aortic arch. * marks the site of potential injury at mediastinoscopy.
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