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Kaya M. Postnatal outcome of fetal aberrant right subclavian artery: a single center study. Arch Gynecol Obstet 2024:10.1007/s00404-024-07488-0. [PMID: 38555333 DOI: 10.1007/s00404-024-07488-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Accepted: 03/16/2024] [Indexed: 04/02/2024]
Abstract
PURPOSE This study aims to explore the correlation between fetal aberrant right subclavian artery (ARSA) and chromosomal disorders, with a specific focus on Down syndrome and DiGeorge syndrome. METHODS From November 2017 to February 2020, we conducted fetal anomaly screening and assessed the fetal heart in 8494 at our institution. The right subclavian artery tracing was assessed using Doppler ultrasonography following the 3-vessel and tracheal views (3VTV) in the fetal heart scan. RESULTS ARSA was found in 31 fetuses, which accounts for 0.36% of the total of 8494 fetuses. 96.8% of fetuses with ARSA were found to have normal chromosomal analysis. We identified only one case of trisomy 21 as the chromosomal condition present. In 80% of the identified ARSA, there were no additional associated findings. CONCLUSION ARSA is a rare condition that often does not manifest any concomitant abnormalities. The majority of ARSA instances identified in the second trimester are euploid. If ARSA is the only sonographic finding during fetal anomaly screening and there are no maternal or laboratory risk factors, further evaluation with non-invasive diagnostics may be recommended. Non-invasive genetic testing may be used for additional investigation.
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Affiliation(s)
- Murat Kaya
- Gaziantep City Hospital Radiology Department, University of Health Science, Ibn-I Sina District, 27470, Şahinbey/Gaziantep, Turkey.
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Luo T, Liu S, Ran S, Dong H, Li Y, Ran Q. Associated congenital anomalies and genetic anomalies in fetuses with isolated and non-isolated aberrant right subclavian artery. J Matern Fetal Neonatal Med 2023; 36:2211705. [PMID: 37258285 DOI: 10.1080/14767058.2023.2211705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 04/25/2023] [Accepted: 05/03/2023] [Indexed: 06/02/2023]
Abstract
OBJECTIVE This study's aim was to determine the prevalence of chromosomal anomalies in fetuses with isolated and non-isolated aberrant right subclavian artery (ARSA) and to evaluate its association with other congenital anomalies. METHODS From September 2018 to October 2021, 668 ARSA cases were diagnosed by prenatal ultrasound in our hospital; cases with missed visits and a lack of chromosomal findings were excluded and 363 cases were eligible for enrollment. General information, ultrasound presentation, chromosomal findings and pregnancy outcomes were retrospectively analyzed. RESULTS Among the 363 cases, 296 were isolated, and 67 were associated with structural abnormalities or soft marker abnormalities. The proportion of fetuses with chromosomal abnormalities in the isolated ARSA group was significantly lower than that in the non-isolated ARSA group (p < .001). In the non-isolated ARSA group, 22 cases were combined with other soft marker abnormalities and 45 cases were combined with structural abnormalities. The most frequent structural abnormality coexisting with ARSA was cardiac malformations (38.81%). CONCLUSION The most common combined malformation in ARSA is intracardiac malformation. Isolated ARSA has a low risk of chromosomal abnormalities, so invasive chromosomal testing is not recommended. Non-isolated ARSA has a high incidence of chromosomal abnormalities, so early karyotyping should be recommended.
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Affiliation(s)
- Tiantian Luo
- Department of Ultrasonics, Women and Children's Hospital of Chongqing Medical University, Chongqing, China
- Department of Ultrasonics, Chongqing Health Center for Women and Children, Chongqing, China
| | - Shuang Liu
- Department of Ultrasonics, Women and Children's Hospital of Chongqing Medical University, Chongqing, China
- Department of Ultrasonics, Chongqing Health Center for Women and Children, Chongqing, China
| | - Suzhen Ran
- Department of Ultrasonics, Women and Children's Hospital of Chongqing Medical University, Chongqing, China
- Department of Ultrasonics, Chongqing Health Center for Women and Children, Chongqing, China
| | - Hongmei Dong
- Department of Ultrasonics, Women and Children's Hospital of Chongqing Medical University, Chongqing, China
- Department of Ultrasonics, Chongqing Health Center for Women and Children, Chongqing, China
| | - You Li
- Department of Ultrasonics, Women and Children's Hospital of Chongqing Medical University, Chongqing, China
- Department of Ultrasonics, Chongqing Health Center for Women and Children, Chongqing, China
| | - Qian Ran
- Department of Ultrasonics, Women and Children's Hospital of Chongqing Medical University, Chongqing, China
- Department of Ultrasonics, Chongqing Health Center for Women and Children, Chongqing, China
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Xue H, Zhang L, Yu A, Lin M, Guo Q, Xu L, Huang H. Prenatal genetic analysis of fetal aberrant right subclavian artery with or without additional ultrasound anomalies in a third level referral center. Sci Rep 2023; 13:3414. [PMID: 36854820 PMCID: PMC9975173 DOI: 10.1038/s41598-023-30598-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Accepted: 02/27/2023] [Indexed: 03/02/2023] Open
Abstract
To evaluate the correlation between chromosomal abnormalities and fetal aberrant right subclavian artery (ARSA) with or without additional ultrasound anomalies (UAs). A total of 340 fetuses diagnosed with ARSA by ultrasound between December, 2015, and July, 2021, were included. All cases were subdivided into three groups: (A) 121 (35.6%) cases with isolated ARSA, (B) 91 (26.8%) cases with soft markers, and (C) 128 (37.6%) cases complicated with other UAs. Invasive testing was performed via amniotic fluid or cord blood karyotyping and chromosomal microarray analysis (CMA) in parallel, and pregnancy outcomes were followed. Karyotype abnormalities were identified in 18/340 (5.3%) patients. Karyotype abnormalities in Groups A, B, and C were 0/121 (0.0%), 7/91 (7.7%), and 11/128 (8.6%), respectively. CMA abnormalities with clinically significant variants were detected in 37/340 (10.9%) cases, of which 22q11.2 deletion syndrome and trisomy 21 accounted for 48.6% (18/37). The overall abnormal CMA with clinically significant variant detection rates in Groups A, B, and C were 3/121(2.5%), 13/91 (14.3%), and 21/128 (16.4%), respectively. There were significant difference in clinically significant CMA anomalies detection rate between Groups A and C (p < 0.05), as well as Groups A and B (p < 0.05). Comparing CMA to karyotyping showed a clinically significant incremental yield in Group C (7.8%, 10/128) compared to Groups A (2.5%, 3/121) and B (6.6%, 6/91) (p > 0.05). Fetal ARSA with additional UAs, concurred with cardiac and extra-cardiac anomalies, constitutes a high-risk factor for chromosomal aberrations, especially for pathogenic or likely pathogenic copy number variants.
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Affiliation(s)
- Huili Xue
- Medical Genetic Diagnosis and Therapy Center, Fujian Key Laboratory for Prenatal Diagnosis and Birth Defect, Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, No. 18 Daoshan Road, Gulou District, Fuzhou City, 350001, Fujian Province, China.
| | - Lin Zhang
- grid.256112.30000 0004 1797 9307Fujian Medical University, No. 88 Jiaotong Road, Cangshan District, Fuzhou City, 350001 Fujian Province China
| | - Aili Yu
- grid.256112.30000 0004 1797 9307Reproductive Medicine Center, Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, No. 18 Daoshan Road, Gulou District, Fuzhou City, 350001 Fujian Province China
| | - Min Lin
- grid.256112.30000 0004 1797 9307Medical Genetic Diagnosis and Therapy Center, Fujian Key Laboratory for Prenatal Diagnosis and Birth Defect, Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, No. 18 Daoshan Road, Gulou District, Fuzhou City, 350001 Fujian Province China
| | - Qun Guo
- grid.256112.30000 0004 1797 9307Medical Genetic Diagnosis and Therapy Center, Fujian Key Laboratory for Prenatal Diagnosis and Birth Defect, Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, No. 18 Daoshan Road, Gulou District, Fuzhou City, 350001 Fujian Province China
| | - Liangpu Xu
- grid.256112.30000 0004 1797 9307Medical Genetic Diagnosis and Therapy Center, Fujian Key Laboratory for Prenatal Diagnosis and Birth Defect, Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, No. 18 Daoshan Road, Gulou District, Fuzhou City, 350001 Fujian Province China
| | - Hailong Huang
- grid.256112.30000 0004 1797 9307Medical Genetic Diagnosis and Therapy Center, Fujian Key Laboratory for Prenatal Diagnosis and Birth Defect, Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, No. 18 Daoshan Road, Gulou District, Fuzhou City, 350001 Fujian Province China
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Annetta R, Nisbet D, O’Mahony E, Palma-Dias R. Aberrant right subclavian artery: embryology, prenatal diagnosis and clinical significance. ULTRASOUND (LEEDS, ENGLAND) 2022; 30:284-291. [PMID: 36969537 PMCID: PMC10034652 DOI: 10.1177/1742271x211057219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 10/14/2021] [Indexed: 11/16/2022]
Abstract
Introduction The right subclavian artery normally arises as the first vessel from the brachiocephalic trunk. An aberrant right subclavian artery (ARSA) arises directly from the aortic arch and crosses behind the trachea towards the right arm. This variant occurs in approximately 1-2% of the population; however, the frequency increases in individuals with chromosomal abnormalities such as trisomy 21 and 22q11.2 microdeletion. Prenatal identification of ARSA therefore has a role in screening for such conditions. Methods Databases were searched for studies reporting the prenatal ultrasound evaluation of ARSA and its frequency in normal fetuses and in those with chromosomal abnormalities. Results A total of 23 studies were evaluated. Feasibility for the ultrasound evaluation of ARSA was 85-95%. The sonographic detection of ARSA is best in the three-vessel trachea view; however, sagittal and coronal imaging of the aortic arch may be useful. ARSA in isolation was not found to be associated with chromosomal abnormalities. The prevalence of ARSA in chromosomally abnormal fetuses was up to 24-fold higher than in normal fetuses, but the majority of chromosomally abnormal fetuses with ARSA had additional abnormal ultrasound findings, particularly cardiac abnormalities. Conclusions The prenatal detection of ARSA is a clinically useful prenatal marker for chromosomal abnormalities. In isolation, it is unlikely to be associated with pathogenic genetic variants. The ultrasound diagnosis of ARSA should prompt meticulous assessment of associated abnormalities. Invasive diagnostic testing should be offered to patients with non-isolated ARSA or in the presence of non-reassuring screening results or other risk factors.
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Affiliation(s)
| | - Debbie Nisbet
- Royal Women’s Hospital, Melbourne, Victoria, Australia
| | | | - Ricardo Palma-Dias
- Royal Women’s Hospital, Melbourne, Victoria, Australia
- Department of Obstetrics and Gynaecology, The University of
Melbourne, The University of Melbourne, The Royal Women’s Hospital,
Parkville, Victoria, Australia
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AYGÜN EG, SARI U, PATA Ö, KUTLU DİLEK TU. İkinci Trimester Muayenesinde Tanı Alan İzole Aberran Sağ Subklavian Arter (ARSA): Nasıl Yaklaşalım? DICLE MEDICAL JOURNAL 2022. [DOI: 10.5798/dicletip.1086300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Stavridis K, Antsaklis P, Theodora M, Tasias K, Daskalakis G. Prenatal diagnosis of aberrant right subclavian artery: a literature review. J Matern Fetal Neonatal Med 2022; 35:8856-8862. [PMID: 35156496 DOI: 10.1080/14767058.2021.2005570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The primary aim of this review is to estimate the prevalence of ARSA both in euploid fetuses as well as in fetuses with Down Syndrome. Secondary objectives were to estimate the association of ARSA with cardiac anomalies and chromosomal defects, especially trisomy 21 and 22q11 deletion (DiGeorge Syndrome). The incidence of ARSA in normal population varies from 0.35% to 3.5%, based on different studies. Since the first reported association between ARSA and trisomy 21 in 2015 until today, several studies have emerged to confirm different degrees of this correlation. Indeed, ARSA appears to be a clinically useful prenatal ultrasound marker for trisomy 21. Particularly, most recent studies concluded that ARSA as a non-isolated finding can be used as screening for Down syndrome. However, when ARSA is an isolated finding, various studies proved that there is no significant correlation with Down syndrome. Apart from these, ARSA appears to be associated with other chromosomal abnormalities, such as 22q11 deletion, cardiac defects and other morphological anomalies. As a conclusion ARSA should be characterized as isolated or non-isolated, as the non - isolated ARSA appears to be a clinically useful marker of Down syndrome and thus, additional testing is required when diagnosed.
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Affiliation(s)
| | - Panos Antsaklis
- First Department of Obstetrics and Gynecology, University of Athens, Athens, Greece
| | - Marianna Theodora
- First Department of Obstetrics and Gynecology, University of Athens, Athens, Greece
| | - Konstantinos Tasias
- First Department of Obstetrics and Gynecology, University of Athens, Athens, Greece
| | - Georgios Daskalakis
- First Department of Obstetrics and Gynecology, University of Athens, Athens, Greece
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Cai M, Lin N, Fan X, Chen X, Xu S, Fu X, Xu L, Huang H. Fetal Aberrant Right Subclavian Artery: Associated Anomalies, Genetic Etiology, and Postnatal Outcomes in a Retrospective Cohort Study. Front Pediatr 2022; 10:895562. [PMID: 35722491 PMCID: PMC9203729 DOI: 10.3389/fped.2022.895562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 05/06/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Aberrant right subclavian artery (ARSA) is becoming increasingly common in fetuses. However, there are relatively fewer studies regarding the genetic etiology of ARSA. We performed a genetic analysis of fetuses with ARSA and followed up on the pregnancy outcomes to evaluate the prognosis of the fetuses, providing information for prenatal and eugenic consultations. METHODS This retrospective study included 112 pregnant females whose fetuses were diagnosed with ARSA from December 2016 to February 2021. Fetal karyotype analysis and single-nucleotide polymorphism (SNP) array were performed. RESULTS The 112 fetuses were divided into two groups: the isolated ARSA group (n = 48, 42.9%) and the non-isolated ARSA group (ARSA with other ultrasound abnormalities, n = 64, 57.1%). The total rate of pathogenic copy number variation (CNV) observed using karyotype analysis (3/8) and SNP array (5/8) was 7.1% (8/112). The rates of pathogenic CNV in the isolated and non-isolated ARSA groups were 4.2% (2/48) and 9.4% (6/64), respectively. No significant difference was observed between the two groups (P = 0.463). The results of genetic analysis influenced the parents' decision to terminate the pregnancy. During the follow-up examination, fetuses with ARSA without pathogenic CNV were found to have normal growth and development after birth. CONCLUSION Fetuses with isolated ARSA have a low probability of being diagnosed with pathogenic CNV. However, when ARSA is complicated with other ultrasound abnormalities, the risk of pathogenic CNV remarkably increases. Prenatal genetic counseling and SNP-array should be recommended for better assessment of fetal prognosis.
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Affiliation(s)
- Meiying Cai
- Medical Genetic Diagnosis and Therapy Center, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fujian Key Laboratory for Prenatal Diagnosis and Birth Defect, Fuzhou, China
| | - Na Lin
- Medical Genetic Diagnosis and Therapy Center, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fujian Key Laboratory for Prenatal Diagnosis and Birth Defect, Fuzhou, China
| | - Xiangqun Fan
- Medical Genetic Diagnosis and Therapy Center, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fujian Key Laboratory for Prenatal Diagnosis and Birth Defect, Fuzhou, China
| | - Xuemei Chen
- Medical Genetic Diagnosis and Therapy Center, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fujian Key Laboratory for Prenatal Diagnosis and Birth Defect, Fuzhou, China
| | - Shiyi Xu
- Guangxi Medical University, Guangxi, China
| | - Xianguo Fu
- Department of Prenatal Diagnosis, Ningde Municipal Hospital, Ningde Normal University, Ningde, China
| | - Liangpu Xu
- Medical Genetic Diagnosis and Therapy Center, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fujian Key Laboratory for Prenatal Diagnosis and Birth Defect, Fuzhou, China
| | - Hailong Huang
- Medical Genetic Diagnosis and Therapy Center, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fujian Key Laboratory for Prenatal Diagnosis and Birth Defect, Fuzhou, China
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Mantri SS, Raju B, Jumah F, Rallo MS, Nagaraj A, Khandelwal P, Roychowdhury S, Kung D, Nanda A, Gupta G. Aortic arch anomalies, embryology and their relevance in neuro-interventional surgery and stroke: A review. Interv Neuroradiol 2021; 28:489-498. [PMID: 34516323 PMCID: PMC9326868 DOI: 10.1177/15910199211039924] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Congenital aortic arch anomalies are commonly encountered during neurointerventional procedures. While some anomalies are identified at an early age, many are incidentally discovered later in adulthood during endovascular evaluations or interventions. Proper understanding of the normal arch anatomy and its variants is pivotal to safely navigate normal aortic arch branches and to negotiate the catheter through anomalies during neurointerventional procedures. This is particularly relevant in the increasingly "transradial first" culture of neurointerventional surgery. Moreover, some of these anomalies have a peculiar predilection for complications including aneurysm formation, dissection, and rupture during the procedure. Therefore, an understanding of these anomalies, their underlying embryological basis and associations, and pattern of circulation will help endovascular neurosurgeons and interventional radiologists navigate with confidence and consider relevant pathologic associations that may inform risk of cerebrovascular disease. METHODS Here, we present a brief review of the basic embryology of the common anomalies of the aortic arch along with their neurological significances and discuss, through illustrative cases, the association of aortic arch anomalies with cerebral vascular pathology. CONCLUSIONS Understanding the aortic arch anomalies and its embryological basis is essential to safely navigate the cerebral vascular system during neurointerventional surgeries.
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Affiliation(s)
- Shilpa S Mantri
- Department of Neurosurgery, 43982Rutgers-Robert Wood Johnson Medical School & University Hospital, USA
| | - Bharath Raju
- Department of Neurosurgery, 43982Rutgers-Robert Wood Johnson Medical School & University Hospital, USA
| | - Fareed Jumah
- Department of Neurosurgery, 43982Rutgers-Robert Wood Johnson Medical School & University Hospital, USA
| | - Michael S Rallo
- Department of Neurosurgery, 43982Rutgers-Robert Wood Johnson Medical School & University Hospital, USA
| | - Anmol Nagaraj
- Department of Neurosurgery, 43982Rutgers-Robert Wood Johnson Medical School & University Hospital, USA
| | - Priyank Khandelwal
- Department of Neurosurgery, 242612New Jersey Medical School & University Hospital, USA
| | - Sudipta Roychowdhury
- Department of Neuroradiology, 12287 Rutgers-Robert Wood Johnson Medical School & University Hospital, USA
| | - David Kung
- Department of Neurosurgery, 242612New Jersey Medical School & University Hospital, USA
| | - Anil Nanda
- Department of Neurosurgery, 43982Rutgers-Robert Wood Johnson Medical School & University Hospital, USA
| | - Gaurav Gupta
- Department of Neurosurgery, 43982Rutgers-Robert Wood Johnson Medical School & University Hospital, USA
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Surgical treatment of esophageal cancer with anomaly of the aortic arch and its branches. Esophagus 2021; 18:489-495. [PMID: 33537959 DOI: 10.1007/s10388-020-00810-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Accepted: 12/22/2020] [Indexed: 02/03/2023]
Abstract
BACKGROUND Anomalies of the aortic arch and its branches rarely develop. The surgery for esophageal cancer may be challenging with the presence of these anomalies. This study is aimed to analyze the influence of these variations during the esophagectomy. METHODS A total of 21 patients with aortic arch and brachiocephalic vessel variations were retrospectively identified from 2013 to 2019. Anomalies were distributed: 15 patients with left-sided aortic arch combined with aberrant right subclavian artery (LAA + ARSA), 2 right-sided aortic arch with mirror-image arch branches (RAA + MIAB), and 4 right-sided aortic arch combined with aberrant left subclavian artery (RAA + ALSA). Perioperative characteristics and long-term survival were analyzed. RESULTS Tumors were mostly located in the upper and middle thorax (42.9% and 47.6%, respectively). Of the 15 patients with LAA + ARSA, 13 underwent McKeown esophagectomy and 2 via transhiatal approach. Left thoracotomy was performed on all 6 patients with RAA. The R0 resection rate was 90.5% (19/21). Recurrent laryngeal nerve (RLN) injury occurred in 2 patients. Two patients died within 30 days postoperatively. Lymph node yield was 23.6 ± 1.2, with a metastasis rate of 38.1% (8/21). The median follow-up time was 18 months. Recurrence occurred in 6 patients (11-35 months) and 4 patients died after recurrence with a median time to death of 21 months (8-47 months). CONCLUSION For resectable esophageal cancer combined with aortic arch and its branches anomalies, satisfactory surgical results can be obtained under careful preoperative evaluation and reasonable surgical approach selection.
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Lourenço CSFP, Carriço AL, Valente FMDS. Prenatal Diagnosis of Aberrant Right Subclavian Artery: Association with Genetic Abnormalities. REVISTA BRASILEIRA DE GINECOLOGIA E OBSTETRÍCIA 2021; 43:452-456. [PMID: 34318470 PMCID: PMC10411214 DOI: 10.1055/s-0041-1732461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Accepted: 05/05/2021] [Indexed: 10/20/2022] Open
Abstract
OBJECTIVE The objective of the present study was to determine the frequency of malformations and chromosomal abnormalities in a population of fetuses with an aberrant right subclavian artery (ARSA). METHODS This is a 6-year retrospective study of fetuses with a prenatal diagnosis of ARSA conducted during the period between September 2013 and June 2019 at a fetal medicine unit. Data were collected from ultrasound, fetal echocardiograms, genetic studies, and neonatal records. RESULTS An ARSA was diagnosed in 22 fetuses. An ARSA was an isolated finding in 18 out of 22 cases (82%). Associated abnormal sonographic findings were found in 4 cases. All cases underwent invasive testing. In 1 of the cases, a chromosomal abnormality was detected (mos 45,X [13]/46,X,e(X) (p22.1q22.1)). No cases of congenital heart disease were found in any of these fetuses. There were two cases in which the postnatal evaluation revealed a malformation: one case of hypospadias and 1 case of cleft palate. CONCLUSION The presence of an isolated ARSA is benign and is not associated with chromosomal abnormalities. The finding of ARSA, however, warrants a detailed fetal ultrasound in order to exclude major fetal abnormalities and other soft markers.
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Affiliation(s)
| | - Ana Luísa Carriço
- Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
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Irakleidis F, Kyriakides J, Baker D. Aberrant right subclavian artery - a rare congenital anatomical variation causing dysphagia lusoria. VASA 2020; 50:394-397. [PMID: 32815461 DOI: 10.1024/0301-1526/a000904] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
An aberrant right subclavian artery (ARSA) is a rare anatomical variation of the aortic arch. Although an incidental finding and asymptomatic in the majority of individuals, an ARSA can cause troubling symptoms during both childhood and in later life. In adulthood, the most common symptom is dysphagia, where the condition is named dysphagia lusoria. In other rare cases it can cause shortness of breath, chronic cough and hoarseness of voice amongst others. We present a case of a 65-year-old female patient who was diagnosed with dysphagia lusoria following a barium swallow examination to investigate a 10-year history of dysphagia. She was further investigated with other imaging modalities to establish her diagnosis. The dysphagia was not progressive, nor did it result in malnutrition, and hence the patient was managed conservatively. There is currently no established guideline to classify the severity of symptoms or radiological findings of this anatomical anomaly. Our case reiterates the importance of such protocols, in order to be able to avoid the risks of an unnecessary surgical procedure, whilst being sure to prevent the undertreatment of affected individuals.
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Affiliation(s)
- Foivos Irakleidis
- Department of Vascular Surgery, Royal Free London NHS Foundation Trust, London, United Kingdom
| | - Jonathon Kyriakides
- Department of Vascular Surgery, Royal Free London NHS Foundation Trust, London, United Kingdom
| | - Daryll Baker
- Department of Vascular Surgery, Royal Free London NHS Foundation Trust, London, United Kingdom
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Kassif E, Tsur A, Shust-Barequet S, Raviv O, Kushnir A, Abu Snenh S, Achiron R, Mazaki-Tovi S, Weisz B, Salem Y, Weissbach T. The “No ARSA” Sign: A Novel Method of Prenatal Screening for Aberrant Right Subclavian Artery. J Clin Med 2020; 9:jcm9082658. [PMID: 32824459 PMCID: PMC7463697 DOI: 10.3390/jcm9082658] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Revised: 08/06/2020] [Accepted: 08/12/2020] [Indexed: 12/25/2022] Open
Abstract
An aberrant right subclavian artery (ARSA) can be overlooked by the conventional method as described by Chaoui et al., due to acoustic shadowing. The aim of this study was to evaluate the feasibility and accuracy of a novel screening method for ARSA by demonstrating the brachiocephalic artery bifurcation, referred to as the “No ARSA” sign. A prospective study conducted at a tertiary care center between 2018 and 2019 included unselected pregnant patients at a median gestational age of 15.1 (14.2–22.1; IQR (inter-quartile range)) weeks, who had been referred for a routine or targeted anomaly scan. All participants were scanned for the presence or absence of ARSA using both the conventional and the novel “No ARSA” methods for validation purposes. A total of 226 unselected patients were enrolled in the study. The “No ARSA” sign was visualized in 218 fetuses (96.5%). In the remaining 8 cases (3.5%), the “No ARSA” sign was not demonstrated. In these fetuses, an ARSA was visualized by the conventional method. The new method exhibited 100% feasibility and was in complete agreement with the conventional method. Intra- and inter-observer agreement was excellent (κ = 1). The results of the study suggest that the “No ARSA” sign is an efficient and reliable screening tool for ARSA.
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Affiliation(s)
- Eran Kassif
- Departments of Obstetrics and Gynecology, Sheba Medical Center, Tel Hashomer, Sackler School of Medicine, Tel Aviv University, Tel Aviv 69978, Israel; (E.K.); (A.T.); (S.S.-B.); (A.K.); (S.A.S.); (R.A.); (S.M.-T.); (B.W.)
| | - Abraham Tsur
- Departments of Obstetrics and Gynecology, Sheba Medical Center, Tel Hashomer, Sackler School of Medicine, Tel Aviv University, Tel Aviv 69978, Israel; (E.K.); (A.T.); (S.S.-B.); (A.K.); (S.A.S.); (R.A.); (S.M.-T.); (B.W.)
| | - Shir Shust-Barequet
- Departments of Obstetrics and Gynecology, Sheba Medical Center, Tel Hashomer, Sackler School of Medicine, Tel Aviv University, Tel Aviv 69978, Israel; (E.K.); (A.T.); (S.S.-B.); (A.K.); (S.A.S.); (R.A.); (S.M.-T.); (B.W.)
| | - Oshrat Raviv
- Departments of Obstetrics and Gynecology, Meir Medical Center, Kfar Saba, Sackler School of Medicine, Tel Aviv University, Tel Aviv 69978, Israel;
| | - Anya Kushnir
- Departments of Obstetrics and Gynecology, Sheba Medical Center, Tel Hashomer, Sackler School of Medicine, Tel Aviv University, Tel Aviv 69978, Israel; (E.K.); (A.T.); (S.S.-B.); (A.K.); (S.A.S.); (R.A.); (S.M.-T.); (B.W.)
| | - Samar Abu Snenh
- Departments of Obstetrics and Gynecology, Sheba Medical Center, Tel Hashomer, Sackler School of Medicine, Tel Aviv University, Tel Aviv 69978, Israel; (E.K.); (A.T.); (S.S.-B.); (A.K.); (S.A.S.); (R.A.); (S.M.-T.); (B.W.)
| | - Reuven Achiron
- Departments of Obstetrics and Gynecology, Sheba Medical Center, Tel Hashomer, Sackler School of Medicine, Tel Aviv University, Tel Aviv 69978, Israel; (E.K.); (A.T.); (S.S.-B.); (A.K.); (S.A.S.); (R.A.); (S.M.-T.); (B.W.)
| | - Shali Mazaki-Tovi
- Departments of Obstetrics and Gynecology, Sheba Medical Center, Tel Hashomer, Sackler School of Medicine, Tel Aviv University, Tel Aviv 69978, Israel; (E.K.); (A.T.); (S.S.-B.); (A.K.); (S.A.S.); (R.A.); (S.M.-T.); (B.W.)
| | - Boaz Weisz
- Departments of Obstetrics and Gynecology, Sheba Medical Center, Tel Hashomer, Sackler School of Medicine, Tel Aviv University, Tel Aviv 69978, Israel; (E.K.); (A.T.); (S.S.-B.); (A.K.); (S.A.S.); (R.A.); (S.M.-T.); (B.W.)
| | - Yishay Salem
- Pediatric Cardiology Unit, Sheba Medical Center, Tel Hashomer, Sackler School of Medicine, Tel Aviv University, Tel Aviv 69978, Israel
- Correspondence: (Y.S.); (T.W.); Tel.: +972-546-250-299 (T.W.)
| | - Tal Weissbach
- Departments of Obstetrics and Gynecology, Sheba Medical Center, Tel Hashomer, Sackler School of Medicine, Tel Aviv University, Tel Aviv 69978, Israel; (E.K.); (A.T.); (S.S.-B.); (A.K.); (S.A.S.); (R.A.); (S.M.-T.); (B.W.)
- Correspondence: (Y.S.); (T.W.); Tel.: +972-546-250-299 (T.W.)
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13
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Aderibigbe OA, Ranzini AC. Is a Fetal Echocardiography Necessary in IVF-ICSI Pregnancies After Anatomic Survey? JOURNAL OF CLINICAL ULTRASOUND : JCU 2020; 48:307-311. [PMID: 32343439 DOI: 10.1002/jcu.22850] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Revised: 03/05/2020] [Accepted: 03/16/2020] [Indexed: 05/22/2023]
Abstract
PURPOSE In vitro fertilization with intracytoplasmic sperm injection (IVF-ICSI) is generally regarded as an indication for fetal echocardiography due to a reported increased risk of congenital abnormalities including cardiac anomalies. In this study we evaluated the utility of fetal echocardiography after anatomic survey in an experienced center. METHODS This was a retrospective case review of in vitro fertilization with intracytoplasmic sperm injection pregnancies who had echocardiography in our institution from January 1996 to October 2010. RESULTS Records from 85 mothers and 110 fetuses were identified. During anatomic survey, six cardiac anomalies were identified, including four ventricular septal defects, one pulmonary-aortic disproportion, and one post-valvular pulmonary artery dilatation. At fetal echocardiography, two of the four ventricular septal defects were confirmed and an additional three were identified. The most common cardiac anomaly seen in our population of IVF-ICSI pregnancies was ventricular septal defect, which was identified in 3.6% of all cases in the neonatal period. Of ventricular septal defects identified in the prenatal period, 71% resolved before birth. CONCLUSION In experienced centers, a fetal echocardiography may not be necessary if the 3 vessels tracheal view of the heart is evaluated and the heart is evaluated carefully for a ventricular septal defect.
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Affiliation(s)
- Oluyemi A Aderibigbe
- Saint Peter's University Hospital, New Brunswick, New Jersey, USA
- MetroHealth Medical Center/Case Western Reserve University, Cleveland, OH, USA
| | - Angela C Ranzini
- Saint Peter's University Hospital, New Brunswick, New Jersey, USA
- MetroHealth Medical Center/Case Western Reserve University, Cleveland, OH, USA
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14
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Qiu Y, Wu X, Zhuang Z, Li X, Zhu L, Huang C, Zhuang H, Ma M, Ye F, Chen J, Wu Z, Yu X, An M, Chen R, Chen J, Guan L, Sang H, Ye Y, Han Y, Chen Z, Qin H, Zhu H, Zhou Y, Zilundu PLM, Xu D, Zhou L. Anatomical variations of the aortic arch branches in a sample of Chinese cadavers: embryological basis and literature review. Interact Cardiovasc Thorac Surg 2019; 28:622-628. [PMID: 30445440 DOI: 10.1093/icvts/ivy296] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Revised: 09/10/2018] [Accepted: 09/22/2018] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES The aim of this study is to determine the incidence and explore the types of aortic arch branch variations found in our cadavers. METHODS The types and incidence of aortic branch variations in 120 cadavers were analysed after careful dissection. RESULTS One hundred and six of 120 cadavers had normal aortic arch branches and gave rise to usual branches, namely the brachiocephalic trunk, the left common carotid artery and the left subclavian artery. The remaining 14 cadavers had 2 basic types of branch variations, thus accounting for an incidence of 11.67%. A total of 9 aortic arches emitted 4 branches; the brachiocephalic trunk, the left common carotid artery, the left vertebral artery and the left subclavian artery (incidence 7.5%). The second subgroup of 5 cadavers also emitted 4 aortic branches: the right common carotid artery, the left common carotid artery, the left subclavian artery and the right subclavian artery (incidence 4.16%). In this group, the right subclavian artery sprung as a distal branch of the aortic arch (descending), thus making a vascular ring that takes a superoposterior course round the back of the trachea and the oesophagus to reach the right side. There was a single cadaver, different from the other 4 aortic branches of the second group which had a common origin for the common carotid arteries, while the left subclavian artery and distally placed right subclavian artery were present. We did not observe any Kommerell's aortic diverticula. CONCLUSIONS The variations of aortic arch branching are complex and diverse due to varied possible alterations in the embryological processes. There is an imperative need for further research on these variations to elucidate the possible relationships with clinical diagnostic or surgical events.
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Affiliation(s)
- Yumin Qiu
- Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou City, Guangdong Province, China
| | - Xiaoxin Wu
- Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou City, Guangdong Province, China
| | - Zhuokai Zhuang
- Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou City, Guangdong Province, China
| | - Xiaozhi Li
- Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou City, Guangdong Province, China
| | - Lei Zhu
- Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou City, Guangdong Province, China
| | - Cijun Huang
- Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou City, Guangdong Province, China
| | - Hongjie Zhuang
- Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou City, Guangdong Province, China
| | - Mingjian Ma
- Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou City, Guangdong Province, China
| | - Feng Ye
- Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou City, Guangdong Province, China
| | - Jing Chen
- Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou City, Guangdong Province, China
| | - Zhiying Wu
- Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou City, Guangdong Province, China
| | - Xiaopei Yu
- Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou City, Guangdong Province, China
| | - Mingjie An
- Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou City, Guangdong Province, China
| | - Rui Chen
- Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou City, Guangdong Province, China
| | - Junyu Chen
- Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou City, Guangdong Province, China
| | - Lizhi Guan
- Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou City, Guangdong Province, China
| | - Hanyi Sang
- Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou City, Guangdong Province, China
| | - Yuyang Ye
- Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou City, Guangdong Province, China
| | - Yueyin Han
- Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou City, Guangdong Province, China
| | - Zhuokai Chen
- Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou City, Guangdong Province, China
| | - Han Qin
- Department of Cardiac Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou City, China
| | - Haoshuai Zhu
- Department of Thoracic Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou City, China
| | - Yingying Zhou
- Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou City, Guangdong Province, China.,Department of Human Anatomy, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou City, Guangdong Province, China
| | - Prince L M Zilundu
- Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou City, Guangdong Province, China.,Department of Human Anatomy, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou City, Guangdong Province, China
| | - Dazheng Xu
- Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou City, Guangdong Province, China.,Department of Human Anatomy, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou City, Guangdong Province, China
| | - Lihua Zhou
- Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou City, Guangdong Province, China.,Department of Human Anatomy, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou City, Guangdong Province, China
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15
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Sagi-Dain L, Singer A, Josefsberg S, Peleg A, Lev D, Samra NN, Bar-Shira A, Zeligson S, Maya I, Ben-Shachar S. Microarray analysis has no additional value in fetal aberrant right subclavian artery: description of 268 pregnancies and systematic literature review. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2019; 53:810-815. [PMID: 30584678 DOI: 10.1002/uog.20208] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Revised: 11/29/2018] [Accepted: 12/18/2018] [Indexed: 06/09/2023]
Abstract
OBJECTIVES Fetal aberrant right subclavian artery (ARSA) is a relatively common sonographic finding. Several studies have reported a significant association between ARSA and Down syndrome, as well as 22q11.2 microdeletion. The objective of this study was to assess the risk of abnormal chromosomal microarray analysis (CMA) findings in a large cohort of pregnancies with fetal ARSA as an isolated, as well as a non-isolated, sonographic anomaly. A secondary objective was to review the literature, examining the frequency of chromosomal microarray aberrations in fetuses with isolated ARSA. METHODS Data from all pregnancies referred for invasive testing and CMA due to sonographic diagnosis of fetal ARSA, between 2013 and 2017, were obtained retrospectively from the computerized database of the Israeli Ministry of Health. The rate of clinically significant CMA findings in these fetuses was compared to that in a local control population of 2752 low-risk pregnancies with normal ultrasound and serum screening results. In addition, a literature search was conducted in PubMed, from inception to February 2018, of original studies in the English language describing the frequency and nature of microscopic and submicroscopic aberrations in fetuses with isolated ARSA. RESULTS Of 246 pregnancies with isolated ARSA that underwent CMA analysis, a clinically significant finding was detected in one (0.4%) pregnancy (trisomy 21). This rate did not differ significantly from that in the control population (P = 0.1574). Of 22 fetuses with non-isolated ARSA, one (4.5%) additional case of trisomy 21 was noted. The frequency of trisomy 21 in this cohort also did not differ from that in the control population (relative risk, 5.5 (95% CI, 0.8-37.6)). The literature search yielded 13 additional relevant papers, encompassing 333 cases of isolated ARSA. Of 579 cases overall (including those of the present study), 13 (2.2%) cases of trisomy 21 were detected, with no cases of 22q11.2 microdeletion. CONCLUSION While an association may exist between non-isolated ARSA and Down syndrome, isolated ARSA might better serve as a soft marker for Down syndrome, rather than a routine indication for invasive prenatal testing. Copyright © 2018 ISUOG. Published by John Wiley & Sons Ltd.
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Affiliation(s)
- L Sagi-Dain
- Genetics Institute, Carmel Medical Center, affiliated to the Ruth and Bruce Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel
| | - A Singer
- Community Genetics, Public Health Services, Ministry of Health, Jerusalem, Israel
| | - S Josefsberg
- Genetics Institute, Kaplan Medical Center, Rehovot, Israel
| | - A Peleg
- Genetics Institute, Carmel Medical Center, affiliated to the Ruth and Bruce Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel
| | - D Lev
- The Rina Mor Institute of Medical Genetics, Wolfson Medical Center, Holon, Israel
| | - N Nasser Samra
- Institute of Human Genetics, Ziv Medical Center, Safed, Israel
| | - A Bar-Shira
- The Genetic Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - S Zeligson
- Medical Genetics Institute, Shaare Zedek Medical Center, Jerusalem, Israel
| | - I Maya
- Recanati Genetics Institute, Beilinson Hospital, Rabin Medical Center, Petach Tikva, Israel
| | - S Ben-Shachar
- The Genetic Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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16
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Rodrigues M, Nunes J, Figueiredo S, Martins de Campos A, Geraldo AF. Neuroimaging assessment in Down syndrome: a pictorial review. Insights Imaging 2019; 10:52. [PMID: 31111268 PMCID: PMC6527671 DOI: 10.1186/s13244-019-0729-3] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Accepted: 03/07/2019] [Indexed: 02/08/2023] Open
Abstract
Down syndrome (DS), or trisomy 21, is the leading genetic cause of intellectual incapacity worldwide, with a reported incidence of about 1 in 1,000 to 1 in 1,100 live births. Besides the several commonly known physical features characteristic of this syndrome present at birth, DS may additionally affect every organ system. In addition, despite the large number of published papers concerning this syndrome, there is scarce literature focusing specifically in the typical neuroimaging features associated with this condition. The aim of this paper is to review and systematize the distinctive characteristics and abnormalities of the central nervous system, head and neck, and spine present in DS patients that should actively be searched for and evaluated by radiologists and/or neuroradiologists.
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Affiliation(s)
- Marta Rodrigues
- Neuroradiology Department, Centro Hospitalar de Vila Nova de Gaia/Espinho, R. Conceição Fernandes, 1079, Vila Nova de Gaia, Portugal.
| | - Joana Nunes
- Neuroradiology Department, Centro Hospitalar de Vila Nova de Gaia/Espinho, R. Conceição Fernandes, 1079, Vila Nova de Gaia, Portugal
| | - Sofia Figueiredo
- Neurology Department, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | | | - Ana Filipa Geraldo
- Neuroradiology Department, Centro Hospitalar de Vila Nova de Gaia/Espinho, R. Conceição Fernandes, 1079, Vila Nova de Gaia, Portugal
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17
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Jahangeer S, Bashir M, Harky A, Yap J. Aberrant subclavian: new face of an old disease. J Vis Surg 2018; 4:108. [PMID: 29963397 DOI: 10.21037/jovs.2018.05.11] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Accepted: 05/04/2018] [Indexed: 01/04/2023]
Abstract
An aneurysm of an aberrant subclavian artery is un usual prevalence of anomalies of aortic arch, with a literature reported prevalence of 2%. Timely elective intervention is of paramount. The advancement in stenting techniques has promoted this practice to be an alternative to conventional open surgical repair which is associated with high rates of perioperative complications including mortality outcomes. However, new faces of this old disease are emerging as we move to novelty and innovation era. We discuss in this review the advancements in this disease entity highlighting and collecting the world experiences.
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Affiliation(s)
- Saleem Jahangeer
- Department of Cardiac Surgery, Barts Heart Centre, St Bartholomew's Hospital, West Smithfield, London, UK
| | - Mohamad Bashir
- Department of Cardiac Surgery, Barts Heart Centre, St Bartholomew's Hospital, West Smithfield, London, UK
| | - Amer Harky
- Department of Cardiac Surgery, Barts Heart Centre, St Bartholomew's Hospital, West Smithfield, London, UK.,School of Medicine, Cardiff University, Cardiff, UK
| | - John Yap
- Department of Cardiac Surgery, Barts Heart Centre, St Bartholomew's Hospital, West Smithfield, London, UK
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18
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Shah N. Prenatal Diagnosis of Aberrant Right Subclavian Artery in Unselected North Indian Population: Significance and Counselling. JOURNAL OF FETAL MEDICINE 2018. [DOI: 10.1007/s40556-018-0168-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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