Figure 2 Axial and coronal computed tomography angiography images demonstrating kinking of the brachiocephalic trunk origin without right subclavian artery stenosis(A) Contrast-enhanced computed tomography angiography (CTA) multiplanar reconstruction in the coronal plane of the thoracic aorta reveals marked kinking/tortuosity at the origin of the brachiocephalic trunk (red arrow) from the aortic arch, measuring approximately 5 cm in length, with smooth vessel walls and absence of calcified plaque or luminal narrowing proximal to the right subclavian artery origin. (B) Maximum intensity projection (MIP) CTA reconstruction in the coronal-oblique plane highlights the severe proximal kinking of the brachiocephalic trunk (red arrow) transitioning smoothly to a normal-caliber proximal right subclavian artery segment (asterisk, ~1 cm diameter); the right vertebral artery origin is patent (white arrowhead), the mid-cervical right vertebral artery courses normally (green arrow), and the thyrocervical trunk arises typically (blue arrow) without displacement. CTA – computed tomography angiography; MIP – maximum intensity projection.