Priya Sarv, Nagpal Prashant
Radiology, University of Iowa Hospitals and Clinics, Iowa City, USA.
Cardiothoracic Radiology, University of Iowa Hospitals and Clinics, Iowa City, USA.
Cureus. 2020 Jul 30;12(7):e9478. doi: 10.7759/cureus.9478.
A double aortic arch (DAA) with atresia is an uncommon cause of a symptomatic vascular ring resulting in trachea-esophageal compression. An atretic double aortic arch can resemble the right aortic arch with a mirror image branching pattern or the right arch with an aberrant left subclavian artery depending upon the level of atresia. The double aortic arch with atresia is difficult to detect on pre-surgical computed tomography angiography or magnetic resonance angiography due to a lack of contrast in the obliterated arch segment. Differentiation of a double arch with atresia from the right aortic arch is vital as an atretic double arch is a form of the complete vascular ring while the right aortic arch may or may not be symptomatic. Knowledge of some key imaging features can help distinguish these entities. In this case report, we discuss an uncommon case of a double aortic arch with atresia between the left common carotid and left subclavian artery. We also describe its close mimics, their embryological basis, and ways to differentiate it from the right aortic arch.
闭锁性双主动脉弓（DAA）是导致气管食管受压的有症状血管环的罕见原因。闭锁性双主动脉弓根据闭锁的水平，可类似于具有镜像分支模式的右主动脉弓或伴有迷走左锁骨下动脉的右主动脉弓。由于闭锁的弓段缺乏造影剂，术前计算机断层血管造影或磁共振血管造影很难检测到闭锁性双主动脉弓。区分闭锁性双主动脉弓与右主动脉弓至关重要，因为闭锁性双主动脉弓是完全血管环的一种形式，而右主动脉弓可能有症状也可能没有症状。了解一些关键的影像学特征有助于区分这些实体。在本病例报告中，我们讨论了一例罕见的左颈总动脉和左锁骨下动脉之间闭锁的双主动脉弓病例。我们还描述了其相似的情况、胚胎学基础以及将其与右主动脉弓区分开来的方法。
