Morphological Evaluation of the Subclavian Artery and Its Branching Variations: A Digital Subtraction Angiography Study

International Journal of Anatomy and Physiology | Vol. 15, No. 10, October 2026 | pp. 73–81

DOI: 10.46882/2026/IJAP/001009

Research Article

Title: Morphological Evaluation of the Subclavian Artery and Its Branching Variations: A Digital Subtraction Angiography Study

Names of Authors: M. A. Al-Qahtani¹, T. J. Henderson², K. V. Subramanian³*

Authors’ Affiliations:
¹ Department of Anatomy, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
² Department of Radiology, Vascular Imaging Center, Edinburgh Royal Infirmary, Edinburgh, United Kingdom.
³ Department of Anatomy, Madras Medical College, Chennai, India.

Abstract:
Understanding the precise branching anatomy of the subclavian artery is critical for preventing complications during thoracic outlet decompressions, central venous catheterizations, and endovascular interventions. This retrospective study used digital subtraction angiography (DSA) to classify the structural variations in the origin and branching patterns of the subclavian artery. A total of 320 diagnostic angiograms (175 males, 145 females) were analyzed. The classic branching pattern—consisting of the vertebral artery, internal thoracic artery, and thyrocervical trunk arising from the first part—was observed on the right side in 78.4% of cases and on the left side in 82.1% of cases. The most frequent variation on the left side was the direct aortic origin of the vertebral artery (5.3%). On the right side, an aberrant right subclavian artery (arteria lusoria) originating as the last branch of the aortic arch was identified in 1.6% of patients, presenting a retroesophageal course. The mean proximal luminal diameter of the subclavian artery was significantly wider in males than in females (9.4 ± 1.1 mm vs. 8.1 ± 0.9 mm; p < 0.05). These variations did not correlate with age or lateral asymmetry. The findings demonstrate that deviation from standard vascular geometry is common, emphasizing the value of using high-resolution DSA maps to minimize risk during upper thoracic and cervical surgical interventions.

Keywords: Subclavian artery, Vertebral artery, Arteria lusoria, Digital subtraction angiography, Anatomical variation.

Manuscript Timeline: Received: June 15, 2026; Revised: August 04, 2026; Accepted: September 01, 2026; Published: October 03, 2026.

Citation: Al-Qahtani MA, Henderson TJ, Subramanian KV. Morphological Evaluation of the Subclavian Artery and Its Branching Variations: A Digital Subtraction Angiography Study. International Journal of Anatomy and Physiology. 2026; 15(10): 73–81. doi:10.46882/2026/IJAP/001009

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