Aberrant subclavian arteries: cross-sectional imaging findings in infants and children referred for evaluation of extrinsic airway compression.
OBJECTIVE
The purpose of our study was to describe patterns of airway compression identified on cross-sectional imaging in infants and children with either right aortic arch and aberrant left subclavian artery or left aortic arch with aberrant right subclavian artery.


METHODS
Data from MR imaging and CT performed to evaluate pediatric patients for extrinsic airway compression were reviewed for cases that revealed an aberrant right or left subclavian artery. Clinical, endoscopic, and imaging findings in identified cases were reviewed. Recurrent patterns of extrinsic compression were reviewed among cases.


RESULTS
Twelve patients with right aortic arch with aberrant left subclavian artery and nine patients with left aortic arch and aberrant right subclavian artery were identified. All 12 with right aortic arch with aberrant left subclavian artery had airway compression shown, with multiple sites or diffuse compression in six. Of these 12 patients, nine had compression at the level of the arch and aberrant subclavian artery (10 had Kommerell's diverticulum), and nine had compression of the distal airway in association with a midline descending aorta. Five of the nine patients with left aortic arch and aberrant right subclavian artery had airway compression shown, all at the level of the arch and aberrant subclavian artery. None of these compressions was associated with either Kommerell's diverticulum or midline descending aorta.


CONCLUSIONS
Both right and left aberrant subclavian arteries can be associated with symptomatic airway compression, but the patterns of compression are different. The airway compression in right aortic arch with aberrant left subclavian artery is often associated with either Kommerell's diverticulum or midline descending aorta, whereas compression associated with left aortic arch and aberrant right subclavian artery is not.
Donnelly
Lane F
LF
Department of Radiology, Children's Hospital Medical Center, 3333 Burnet Ave., Cincinnati, OH 45229-3039, USA.
Fleck
Robert J
RJ
Pacharn
Preeyacha
P
Ziegler
Matthew A
MA
Fricke
Bradley L
BL
Cotton
Robin T
RT
D000402:Airway Obstruction / Q000151:congenital* / Q000000981:diagnostic imaging / Q000473:pathology*; D001013:Aorta, Thoracic / Q000002:abnormalities / Q000000981:diagnostic imaging / Q000473:pathology; D001018:Aortic Diseases / Q000151:congenital* / Q000000981:diagnostic imaging / Q000473:pathology*; D002648:Child; D002675:Child, Preschool; D002828:Choristoma / Q000151:congenital* / Q000000981:diagnostic imaging / Q000473:pathology*; D005260:Female; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging; D008297:Male; D012017:Referral and Consultation; D012189:Retrospective Studies; D013348:Subclavian Artery / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000473:pathology*; D014057:Tomography, X-Ray Computed