FIBROMUSCULAR HYPERPLASIA IN AN ABERRANT SUBCLAVIAN ARTERY AND NEUROGENIC THORACIC OUTLET SYNDROME - AN UNUSUAL COMBINATION

An aberrant right subclavian artery arising distal to the origin of th e left subclavian artery is the most common anomaly of the aortic arch . Degenerative diseases of aberrant subclavian arteries including aneu rysms and occlusive disease have been reported previously. We believe that this case is the first reported case of fibromuscular hyperplasia affecting an aberrant subclavian artery. A 25-year-old woman admitted with a history consistent with neurogenic thoracic outlet syndrome wa s found to have a reduced pulse and blood pressure on the ipsilateral side caused by fibromuscular hyperplasia of an aberrant subclavian art ery. A carotid-subclavian bypass via a supraclavicular incision was pe rformed at the same time as thoracic outlet decompression. Histologic examination confirmed the presence of fibromuscular hyperplasia in the aberrant subclavian artery. This case is discussed with reference to the available literature.