In one case reported by Pantvaidya ( 8), the aberrant right subclavian artery was transected during video assisted thoracoscopic esophagectomy before being recognized and required an immediate vascular reconstruction via a median sternotomy. To our knowledge, this the fourth case in published literature describing the aberrant right subclavian artery in patients undergoing esophagectomy ( 5, 8, 9). This artery originates from the aortic arch (arrow head) and parallels to the esophagus. Thoracotomy has been converted and a retro-esophageal right subclavian artery (arrow) in a diameter of 1.5 cm is identified. At 3 months follow-up, there was no incidence of morbidity.įigure 2. This patient was discharged on day 8 after operation. Subsequent operative procedures were then safely performed, and this aberrant artery was kept intact. This artery originates from the aortic arch and parallels to the esophagus. We identified a retro-esophageal right subclavian artery in a diameter of 1.5 cm ( Figure 2), which was thought to be the azygos vein according to a pre-operative enhanced chest CT scan ( Figure 1). In order to investigate this aberrant vessel, the operation was converted to thoracotomy. During dissection of upper segment of thoracic esophagus, an aberrant pulsing vessel was encountered the level above aortic arch and in the space between spine and esophagus. After pre-operative preparation, a video-assisted thoracoscopic esophagectomy was performed through right thoracic approach under double luminal intro-tracheal incubation and general anesthesia. Biopsy was performed and pathological diagnosis of squamous carcinoma was confirmed. Upper gastrointestinal endoscopy revealed an intraluminal esophageal neoplasm 23 cm distal to his incisor ( Figure 1). We reported a case of aberrant artery encountered during video-assisted thoracoscopic esophagectomy.Ī 57-year-old male was presented to our department with progressive dysphagia for more than 3 months. However, an aberrant right subclavian artery may appear in this area and lead to disastrous complications. When performing video-assisted thoracoscopic esophagectomy, the area at the level above the aortic and in the space between the esophagus and the spine, is usually regarded as a safe area for dissection of upper segment of thoracic esophagus. Formation of abnormal retroesophageal subclavian artery is hypothesized to be the result of the persistence of the intersegmental artery caused by the abnormal involution of the fourth right aortic arch ( 7, 8). During normal embryo evolution, the proximal part of right subclavian artery develops from the right fourth primitive aortic arch and the distal from the seventh intersegmental artery ( 4- 6). The reported incidence of such an aberrant varies from less than 1% to 2% ( 1- 3). Accepted for publication Jul 07, 2013.Īn aberrant right subclavian artery originating from aortic arch was very rare. Interviews with Outstanding Guest EditorsĪberrant subclavian artery video-assisted thoracoscopic surgery esophagectomy (VATS esophagectomy).Policy of Dealing with Allegations of Research Misconduct.Policy of Screening for Plagiarism Process.GameStop's meme stock story is so intriguing that a movie was created about it, called “ Dumb Money." The company's shares took off two years ago after a band of smaller-pocketed investors helped boost its stock 1,000% in two weeks. A new film based on the GameStop stock frenzy, "Dumb Money," is premiering at the Toronto International Film Festival. In this image from video provided by the House Financial Services Committee, Keith Gill, a GameStop investor, also known in social media forums as Roaring Kitty, testifies during a virtual hearing on GameStop in Washington, on Feb. Gamers no longer needed GameStop because they were downloading games, rather than buying digital discs. Cohen co-founded Chewy, the online pet supply company, and had hoped to modernize GameStop, founded in 1984.Ĭohen began snapping up large stakes of GameStop at a time when the company was being buffeted by new technology. By clicking Sign up, you agree to our privacy policy.Ĭohen’s holding company RC Ventures is the biggest investor in GameStop, holding about a 12% stake.
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