Wu Yao-Kun, Mao Qi, Zhou Mao-Ting, Liu Ning, Yu Xi, Peng Jin-Cheng, Tao Yun-Yun, Gong Xue-Qin, Yang Lin, Zhang Xiao-Ming
Medical Imaging Key Laboratory of Sichuan Province, Nanchong 637000, Sichuan Province, China.
Medical Research Center, Department of Radiology, The Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, Sichuan Province, China.
World J Clin Cases. 2022 Apr 6;10(10):3291-3296. doi: 10.12998/wjcc.v10.i10.3291.
A cervical aortic arch (CAA) refers to a high-riding aortic arch (AA) that often extends above the level of the clavicle. This condition is very rare, with an incidence of less than 1/10000.
A 29-year-old woman was admitted to the otolaryngology department of our hospital for repeated bilateral purulent nasal discharge for the prior 3 mo. The patient was diagnosed with chronic sinusitis and chronic rhinitis at admission. A preoperative noncontrast chest computed tomography scan showed a high-riding, tortuous AA extending to the mid-upper level of the first thoracic vertebra with local cystic dilatation. A further computed tomography angiography examination showed that the brachiocephalic trunk, left common carotid artery, left vertebral artery (LVA) (slender), and left subclavian artery sequentially branched off of the aorta from the proximal end to the distal end of the AA. The proximal end of the right subclavian artery (RSCA) was tortuous and dilated. The AA showed tumor-like local expansion, with a maximum diameter of approximately 4 cm. After consultation with the department of cardiac macrovascular surgery, the patient was diagnosed with left CAA with aneurysm formation and an anomalous RSCA and LVA and was transferred to that department. The patient underwent AA aneurysm resection and artificial blood vessel replacement under general anesthesia and cardiopulmonary bypass. No abnormality was found during the 2-mo follow-up after discharge.
A CAA is a rare congenital anomaly of vascular development. The present unique case of CAA with aneurysm formation and an anomalous RSCA and LVA enriches existing CAA data.
颈主动脉弓（CAA）是指高位主动脉弓（AA），常延伸至锁骨水平以上。这种情况非常罕见，发病率低于1/10000。
一名29岁女性因之前3个月反复双侧脓性鼻分泌物入住我院耳鼻喉科。入院时患者被诊断为慢性鼻窦炎和慢性鼻炎。术前胸部非增强计算机断层扫描显示高位、迂曲的主动脉弓延伸至第一胸椎中上段水平，伴有局部囊性扩张。进一步的计算机断层扫描血管造影检查显示，头臂干、左颈总动脉、左椎动脉（纤细）和左锁骨下动脉从主动脉弓近端到远端依次分支。右锁骨下动脉（RSCA）近端迂曲、扩张。主动脉弓呈瘤样局部扩张，最大直径约4cm。经心脏大血管外科会诊，患者被诊断为左颈主动脉弓伴动脉瘤形成、右锁骨下动脉和左椎动脉异常，遂转入该科室。患者在全身麻醉和体外循环下接受了主动脉弓动脉瘤切除术和人工血管置换术。出院后2个月随访未发现异常。
颈主动脉弓是一种罕见的先天性血管发育异常。目前这例独特的颈主动脉弓伴动脉瘤形成、右锁骨下动脉和左椎动脉异常的病例丰富了现有的颈主动脉弓数据。
