The simultaneous presence of a bicarotid trunk and a retroesophageal right subclavian artery: a case report

Many variations exist in the branching pattern of the aortic arch. One variation exists in which there is a common origin of the carotid arteries, known as a bicarotid trunk, coexisting with a retroesophageal right subclavian artery. This anomaly is associated with a right non-recurrent laryngeal nerve. Aortic arch anomalies are clinically applicable to the fields of anatomy, radiology, general medical practice, as well as thoracic and cardiovascular surgery. Here, we report a case of an uncommon branching pattern of the aortic arch identified during anatomical dissection and supported by antemortem diagnostic imaging. The anatomical variant was discovered in an 89year-old Caucasian male during a routine anatomical dissection and was characterized by a bicarotid arterial trunk, left subclavian artery, followed by a retroesophageal right subclavian artery. Additionally, a right non-recurrent inferior laryngeal nerve was present. In the absence of clinical symptoms, the relevance of this variant is most evident in the case of cardiovascular or laryngeal surgeries. With advanced imaging such as CT and MRI, this type of vascular anomaly should be properly identified and described. The variation presented has particular interest to general practitioners, radiologists, and cardiovascular and thoracic surgeons.