Chest X-ray findings suggesting aberrant subclavian artery: Implications for avoiding the right radial approach

Performing coronary angiography via the radial approach in patients with aberrant subclavian artery can result in procedural difficulty, necessitating a change of access route and potentially increasing the risk of vascular complications. We report a case of acute coronary syndrome in which an aberrant subclavian artery was incidentally identified, leading to a switch in access site during coronary angiography. This case underscores the importance of recognizing aberrant subclavian artery as a potential finding on chest X-rays in patients prior to coronary angiography. • Aberrant subclavian arteries may cause procedural difficulty and delay during transradial coronary angiography. • Aberrant subclavian arteries are typically asymptomatic and often discovered incidentally during transradial coronary angiography. • This case highlights that abnormalities of the subclavian artery may be detectable on chest X-ray prior to coronary angiography.