Isolation of the subclavian artery: 4 cases report and literature review.

Isolation of the subclavian artery was first described in 1964 [1]. The term ‘‘isolation’’ means that the subclavian artery arises exclusively from the pulmonary artery via the ductus arteriosus rather than from the aortic arch. On the basis of embryology, subclavian isolation is always on the contralateral side of aortic arch [2]. The incidence of right aortic arch with isolated left subclavian artery (LSA) is very rare, accounting for only 0.8% of 298 right arch cases [3]. In 1990, Leutmer and Miller review the literature to 1990 and showed 39 cases of right arch with isolated LSA [4]. In contrast, the incidence of the isolated right subclavian artery (RSA) in left aortic arch is far less, and about only one fourth of the left one [2]. We report four patients with isolated subclavian artery. Two of them are right arch with isolated LSA, the other two are left arch with isolated RSA. We also review the literature regarding this congenital vascular anomaly.