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