A case of bilateral anomalous origins of the vertebral arteries (VAs) is reported. Both VAs arose directly from the aortic arch between the left common carotid artery and the left subclavian artery. The possible embryologic mechanism and clinical importance of this previously unreported variant are reviewed.

Angiography in a 30-year-old man revealed the unique combination of aortic coarctation and an unusual arch anomaly. Proximal to the coarctation, a single arch vessel trifurcated into the brachiocephalic, left common carotid and left subclavian arteries. This anomalous arch vessel is a normal equine variant.

The internal thoracic (mammary) nerve is formed by contributions from the subclavian plexus and the phrenic nerve. It descends along the internal thoracic artery to the level of the seventh costal cartilage where it is lost. Some of its branches communicate with the intercostal nerves -and are thought to be distributed with these nerves. Others follow perforating and anterior mediastinal arteries.

A case of incidental ductal aortic coarctation with left subclavian artery stenosis at the origin, severely calcified and stenotic bicuspid aortic valve, and normal coronary arteries demonstrated by single breath hold dual source computed tomography angiography in a 46-year-old man admitted for acute chest pain is presented.

Angiography and intervention of a LIMA (left internal mammary artery) graft cannot be performed easily while working through right transradial approach (TRA), because of complexity in anatomical relations of right and left subclavian arteries with arch of aorta. We demonstrate two simple and innovative techniques for the same using right TRA.

Isolated subclavian vein injuries are rarely seen without concomitant arterial injury, bone fracture, damage to brachial plexus, and thoracal traumas. Our case was brought to the emergency service 6 hours after he had been shot at the shoulder with a firearm. After detection of extravasation from the left axillary and subclavian vein on arteriographic and venographic examinations, he was operat...