PC004. Classification of Aberrant Subclavian Arteries and Their Association With Aortic Disease

Aberrant subclavian artery (aSCA) is a rare anatomic variant that can be associated with other aortic branch variations and disease. Understanding of associated variations and pathologic processes is important for open and endovascular management, including operative planning. We describe the incidence of variations, diseases, and symptoms in a large cohort of consecutive patients with aSCA. All thoracic axial imaging studies at Keck Hospital of University of Southern California from 2006 to 2018 were queried for presence of aSCA. Scans were evaluated for aSCA laterality, associated variant anatomy, and aortic and branch vessel disease. Medical records were reviewed for sex, symptoms, and associated diagnoses. Of 98,580 axial imaging studies, 810 studies (0.82%) were identified with aSCA, of which there were 312 unique patients. Right aSCA (aRSCA) occurred in 90.1%, whereas left (aLSCA) occurred in 9.9%. aSCA coursed retroesophageal in 100%, and 185 (59.3%) had a Kommerell diverticulum (KD; 56.2% of aRSCAs, 83.9% of aLSCAs; P = .0003) with an average diameter of 1.67 cm (range, 1.2-3.3 cm). Men more frequently had a KD (73.3% vs 50%; P < .0001) and had a larger KD (1.81 cm vs 1.54 cm; P < .0001). The aLSCA had a larger KD than the aRSCA (2.05 cm vs 1.61 cm; P