Subclavian Artery: Anatomic Review and Imaging Evaluation of Abnormalities

The subclavian artery is an important structure that may be over-looked at CT of the chest and neck, in part because of its anatomic location at the periphery of the field of view but also because the clinical indication for CT examinations infrequently directs atten-tion specifically to evaluation of the subclavian artery. As with all arteries, the subclavian artery has the potential to be involved in a variety of abnormalities, including pseudoaneurysms, dissections, stenosis or thrombosis, and vasculopathies. In addition, the subcla-vian artery can be secondarily involved as a collateral pathway because of an abnormality elsewhere. The subclavian artery may also be involved in surgical procedures to supply blood to other sites in the body or as an arterial access site. In these cases, recognizing the postsurgical appearance of the subclavian artery has become in-creasingly complex because of the use of the artery in an increasing number of procedures. Recognizing expected postoperative changes remains important to avoid mistaking them for abnormalities. The authors describe the imaging appearance of the normal anatomy of the subclavian artery and its anatomic variants, related abnormali-ties, and important postsurgical considerations.