What does this research mean for the field?

A persistent fifth aortic arch (PFAA) can be associated with an isolated left subclavian artery (ILSA) in patients with Tetralogy of Fallot (TOF). Novelty: ClaimNovelty.NOVEL_FINDING. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To describe a rare association of persistent fifth aortic arch with isolated left subclavian artery in a patient with Tetralogy of Fallot.

February 27, 2026Indian journal of radiology and imaging - new series/Indian journal of radiology and imaging/Indian Journal of Radiology & Imaging0 citationsOpen Access

Unusual Association of Arch Anomalies: Fifth Arch Remnant with Isolated Left Subclavian Artery

MJMary Varunya Jehendran SGSuraj Gowda RKRicha Kothari

Key Points

To describe a rare association of persistent fifth aortic arch with isolated left subclavian artery in a patient with Tetralogy of Fallot.
Reported a case of an 11-month-old female with Tetralogy of Fallot.
Used cardiac computed tomography for imaging assessment.
Identified a double-lumen aortic arch and nonvisualized left subclavian artery.
Confirmed diagnosis of persistent fifth aortic arch and isolated left subclavian artery.
Highlighted the need for advanced imaging in complex cases of congenital heart defects.
Illustrated unusual vascular configurations associated with Tetralogy of Fallot.

Abstract

We report a rare case of a persistent fifth aortic arch (PFAA) associated with an isolated left subclavian artery (ILSA) in a patient with Tetralogy of Fallot (TOF). We report an 11-month-old female with TOF, in whom cardiac computed tomography revealed a double-lumen aortic arch and nonvisualized origin of the left subclavian artery, consistent with PFAA and ILSA. This case highlights the importance of advanced imaging in identifying complex congenital vascular anomalies.

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