CTICasesDouble Aortic Arch with Atretic Left Segment and Isolated Left Subclavian Artery
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Imaging findings
Chest radiographs and CT angiography demonstrate a vascular ring formed by a double aortic arch, featuring a dominant right arch and a smaller, lower left arch with an atretic segment. There is also an isolated left subclavian artery that has no proximal connection to the aorta, instead reconstituting via retrograde flow from the left vertebral artery, which may cause subclavian steal symptoms.
Key takeaways
A double aortic arch can present with a fibrous or atretic segment in one of the arches, occasionally occurring in combination with an isolated subclavian artery. Retrograde flow through the vertebral artery supplies the isolated subclavian artery in a classic subclavian steal pattern.
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