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Truncus Bicaroticus and an Aberrant Right Subclavian Artery Contributing to Internal Jugular Venous Line Misplacement into the Carotid Artery

Truncus bicaroticus, or common origin of the carotid arteries, is extremely rare and has been described sparsely in the literature. It has been reported as an incidental finding during cadaveric dissection and as an anatomic variant found during routine angiography. We report the case of a 75-year-old woman with a previously unknown truncus bicaroticus and an aberrant right subclavian artery in whom the anatomic variations contributed to an arterially placed central venous catheter remaining undetected. This catheter misplacement was suspected after the patient developed an embolic stroke, and subsequent studies demonstrated the truncus bicaroticus and intra-arterial catheter placement. To our knowledge, this is the first case reporting a truncus bicaroticus associated with an aberrant right subclavian artery.