Innominate artery compression syndrome, also known as brachiocephalic artery compression syndrome, is a rare cause of tracheal stenosis that occurs in the pediatric population. It is due to abnormal compression of the anterior aspect of the trachea as the brachiocephalic artery crosses it.
On this page:
Diagnosis
The diagnosis of innominate artery compression syndrome requires the combination of:
presence of obstructive symptoms
brachiocephalic artery origin to the left of the trachea
presence of tracheal narrowing on dynamic imaging or bronchoscopy at the level at which the brachiocephalic artery crosses
Clinical presentation
Diagnosis should be considered in children less than 3 years with stridor, breathing difficulties, asthma, apneic spells, and recurrent respiratory infections 6.
Pathology
The brachiocephalic artery commonly takes its origin from the left of the trachea in normal children without obstructive symptoms or associated tracheal compression 5. The artery subsequently impinges on the trachea as it traverses anteriorly at the level of the thoracic inlet.
Radiographic features
Tracheal compression by the brachiocephalic artery can be demonstrated on tracheography, CT, or MRI.
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 brachiocephalic artery gradually shifts rightward and so many children outgrow any tracheal impingement.
Unable to process the form. Check for errors and try again.