Solitary Intercostal Arterial Trunk

During embryonic life, events may alter the normal growth and fusion of the endocardial tube, the paired dorsal aortae, and the vitelline plexus, leading to anomalies and variants of the mature axial arterial system.1 Many of these are well known, especially those associated with the aorta, heart, and umbilical artery.1,2 Vitelline variants have also been found that are either associated with Meckel diverticulum or caudal regression syndrome.3,4 We present a case of anomalous intercostal arterial supply, which, to our knowledge, has not been reported previously. The aberrant intercostal trunk is associated with aberrant descending thoracic aorta position, a replaced common hepatic artery from the superior mesenteric artery, and an isolated splenic artery origin from the aorta. A 27-year-old man with a medical history of irritable bowel syndrome and stage I hypertension presented for renal vasculature evaluation. A renal arterial magnetic resonance angiogram (not shown) and subsequent thoraco-