CTICasesDouble Aortic Arch with Atretic Segment
Imaging findings
Chest CT angiogram shows a four-vessel aortic arch anatomy with a right-sided aortic arch and a posterior-lying diverticulum-like dimple at the site of the left-sided arch remnant. The left subclavian artery is tethered and pulled posteriorly toward this diverticulum. There is no patent left-sided arch, but the configuration creates a complete vascular ring around the trachea and esophagus.
Key takeaways
Double aortic arch is the most common cause of a symptomatic vascular ring. In many cases, one of the arches, typically the left, is atretic and persists as a fibrous band rather than a patent lumen. The presence of a diverticular structure and posterior tethering of the left subclavian artery are key imaging markers of this congenital anomaly.
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