CTICasesDouble Aortic Arch (Asymptomatic)
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Imaging findings
A radiograph showed a narrowed trachea, paratracheal stripe thickening, and a suspected vessel. Subsequent CT confirmed a double aortic arch with a classic appearance: the right arch larger than the left, descending on the opposite (left) side of the dominant arch, and presenting with a four-vessel sign (symmetric four vessels).
Key takeaways
This case demonstrates an asymptomatic double aortic arch in an older patient (54 years old), where the vascular ring was loose enough not to cause tracheal or esophageal compression. While often presenting in childhood with symptoms of a vascular ring, it can be an isolated, incidental anomaly discovered later in life. Radiographic clues like tracheal narrowing can prompt further investigation.
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