Vascular rings and slings
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At the time the article was created Henry Knipe had no recorded disclosures.View Henry Knipe's current disclosures
At the time the article was last revised Ashesh Ishwarlal Ranchod had no financial relationships to ineligible companies to disclose.View Ashesh Ishwarlal Ranchod's current disclosures
Vascular rings are rare, occurring in <1% of patients 1. No gender or ethnic predispositions have been identified 3.
Vascular rings can be classified as complete (mostly symptomatic) or incomplete (mostly asymptomatic) 5.
Causes of vascular rings and slings commonly include 1:
double aortic arch (the most common symptomatic vascular ring)
aberrant right subclavian artery (most common)
not considered a complete vascular ring
Radiographic features will differ depending on the underlying anomaly.
Abnormal contour to the trachea may be visible on plain film, as may a right-sided aortic arch.
On contrast esophagogram (and air tracheogram), the pattern of indentations on the frontal and lateral views helps to narrow the differential:
anterior esophageal indentation, posterior tracheal indentation
posterior esophageal indentation, tracheal buckling to the right
posterior esophageal indentation, tracheal buckling to the left
aberrant left subclavian artery with right aortic arch
anterior tracheal indentation in infants
posterior and bilateral esophageal indentation, anterior and bilateral tracheal indentation
allow precise demonstration of the anomaly
Possible considerations include:
- 1. Janet Reid, Edward Lee, Angelisa Paladin et al. Pediatric Radiology. (2014) ISBN: 9780199755325 - Google Books
- 2. Etesami M, Ashwath R, Kanne J, Gilkeson R, Rajiah P. Computed Tomography in the Evaluation of Vascular Rings and Slings. Insights Imaging. 2014;5(4):507-21. doi:10.1007/s13244-014-0343-3 - Pubmed
- 3. Türkvatan A, Büyükbayraktar F, Olçer T, Cumhur T. Congenital Anomalies of the Aortic Arch: Evaluation with the Use of Multidetector Computed Tomography. Korean J Radiol. 2009;10(2):176-84. doi:10.3348/kjr.2009.10.2.176 - Pubmed
- 4. Berdon W. Rings, Slings, and Other Things: Vascular Compression of the Infant Trachea Updated from the Midcentury to the Millennium--The Legacy of Robert E. Gross, MD, and Edward B. D. Neuhauser, MD. Radiology. 2000;216(3):624-32. doi:10.1148/radiology.216.3.r00se40624 - Pubmed
- 5. William T. O'Brien. Top 3 Differentials in Radiology. (2010) ISBN: 9781604062267 - Google Books
- 6. Schuster T, Hecker W, Ring-Mrozik E, Mantel K, Vogl T. Tracheal Stenosis by Innominate Artery Compression in Infants: Surgical Treatment in 35 Cases. Prog Pediatr Surg. 1991;27:231-43. doi:10.1007/978-3-642-87767-4_13 - Pubmed