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Innominate artery compression syndrome

Case contributed by Mostafa Elfeky
Diagnosis almost certain

Presentation

Dyspnea.

Patient Data

Age: 1 year
Gender: Male

CT Chest

ct

The mid-thoracic trachea shows evidently compressed lumen in AP direction, nearly 50 % as compared to the proximal and distal segments, created by brachiocephalic artery arising normally from the aortic arch on the left side of the trachea (slightly lower position than expected) and crossing anterior to it compressing its ventral wall.

Case Discussion

Brachiocephalic (Innominate) artery compression syndrome is a rare cause of tracheal stenosis that occurs in the pediatric population where the brachiocephalic artery usually takes its origin to the left of the trachea and subsequently compresses the trachea as it traverses anteriorly at the level of the thoracic inlet. This is forced by an aberrantly positioned thymus that displaces the aortic arch or innominate artery from its normal position.

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