Polednak Anthony P
Retired, Connecticut Tumor Registry, Connecticut Department of Public Health, Hartford, Connecticut.
Clin Anat. 2017 Nov;30(8):1024-1028. doi: 10.1002/ca.22905. Epub 2017 Jun 15.
The aberrant or anomalous right subclavian artery (ARSA), which arises directly from the aortic arch and crosses to the right side usually behind the esophagus, is a rare but clinically important anatomical variant. A published systematic review (SR) of 15 cadaveric studies on ARSA reported that prevalence ranged from 0.2% to 13.3% of the general population; the total unweighted prevalence of ARSA was 325 cases in 13,208 bodies or 2.46%. The present review, however, found that the 13.3% figure was for 133 cases from a larger case series without a denominator. Three other studies either had an imprecise denominator or were limited to congenital conditions associated with ARSA. After exclusions and modifications, ARSA prevalence for the remaining 11 studies in the SR ranged from 0.19%, with a 95% confidence interval (CI) of 0.00-1.08%, to 2.52% (CI= 0.69-6.32%). The unweighted prevalence for all 11 studies combined was 1.23%, and the pooled prevalence estimate from a meta-analysis was 1.30% (CI = 0.86-1.82%). In conclusion, overall findings from SRs on the prevalence of rare anatomical variants such as ARSA may be affected by outliers. Clin. Anat. 30:1024-1028, 2017. © 2017 Wiley Periodicals, Inc.
迷走或异常右锁骨下动脉（ARSA）直接起自主动脉弓，通常在食管后方 crossing 至右侧，是一种罕见但具有临床重要性的解剖变异。一项已发表的对15项关于ARSA的尸体研究的系统评价（SR）报告称，普通人群中其患病率在0.2%至13.3%之间；ARSA的总未加权患病率为13208具尸体中有325例，即2.46%。然而，本评价发现，13.3%这个数字来自一个较大病例系列中的133例，没有分母。其他三项研究要么分母不精确，要么仅限于与ARSA相关的先天性疾病。经过排除和修正后，SR中其余11项研究的ARSA患病率范围为0.19%，95%置信区间（CI）为0.00 - 1.08%，至2.52%（CI = 0.69 - 6.32%）。所有11项研究合并后的未加权患病率为1.23%，荟萃分析得出的合并患病率估计值为1.30%（CI = 0.86 - 1.82%）。总之，关于ARSA等罕见解剖变异患病率的SR的总体结果可能会受到异常值的影响。《临床解剖学》30:1024 - 1028，2017年。© 2017威利期刊公司
