Innominate artery compression syndrome

Dr Zishan Sheikh et al.

Innominate artery compression syndrome, also known as brachiocephalic artery compression syndrome, is a rare cause of tracheal stenosis that occurs in the paediatric population.

It can only occur in the presence of an aberrantly positioned thymus that forces the aortic arch or innominate artery to deviate from its normal position.

The brachiocephalic or innominate artery usually takes its origin to the left of the trachea. The artery subsequently impinges on the trachea as it traverses anteriorly at the level of the thoracic inlet. Compression can be demonstrated on tracheography, CT or MRI.

It should be noted that the innominate artery can take its origin from the left of the trachea in patient's without obstructive symptoms or associated tracheal compression. 

Authors have suggested surgical repair if tracheal luminal stenosis exceeds 70% in symptomatic patients. Surgical repairs usually involves aortopexy to fix the aortic arch and fixation of the innominate artery to the sternum.

As children grow the origin of the innominate artery gradually shifts rightward and so many children outgrow any tracheal impingement.

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Article information

rID: 47451
Section: Gamuts
Tag: cases
Synonyms or Alternate Spellings:
  • Brachiocephalic artery compression syndrome

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