CTICasesTracheal Stenosis from Left Subclavian Artery Aneurysm
Imaging findings
Chest CT demonstrates a dilated, atherosclerotic aortic arch with a large left subclavian artery aneurysm containing eccentric layering thrombus. The trachea is severely compressed, exhibiting a "nutcracker" narrowing where it is pinched between the dilated subclavian aneurysm and the ectatic aortic arch.
Key takeaways
Extrinsic tracheal stenosis can be caused by adjacent vascular structures, particularly when multiple dilated or aneurysmal vessels restrict the trachea's mobility. A combination of an aortic arch ectasia and a subclavian artery aneurysm can pinch the trachea in a "nutcracker" fashion, leading to significant upper airway obstruction and stridor.
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