Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Apr 6, 2022; 10(10): 3291-3296
Published online Apr 6, 2022. doi: 10.12998/wjcc.v10.i10.3291
Cervical aortic arch with aneurysm formation and an anomalous right subclavian artery and left vertebral artery: A case report
Yao-Kun Wu, Qi Mao, Mao-Ting Zhou, Ning Liu, Xi Yu, Jin-Cheng Peng, Yun-Yun Tao, Xue-Qin Gong, Lin Yang, Xiao-Ming Zhang
Yao-Kun Wu, Qi Mao, Mao-Ting Zhou, Ning Liu, Xi Yu, Jin-Cheng Peng, Yun-Yun Tao, Xue-Qin Gong, Xiao-Ming Zhang, Medical Imaging Key Laboratory of Sichuan Province, Nanchong 637000, Sichuan Province, China
Yao-Kun Wu, Qi Mao, Mao-Ting Zhou, Ning Liu, Xi Yu, Jin-Cheng Peng, Yun-Yun Tao, Xue-Qin Gong, Lin Yang, Xiao-Ming Zhang, Medical Research Center, Department of Radiology, The Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, Sichuan Province, China
Author contributions: Wu YK wrote the paper; Mao Q, Zhou MT, Liu N, Yu X, Peng JC, Tao YY and Gong XQ contributed to the literature search and manuscript preparation; Yang L and Zhang XM designed the study; all of the authors read and approved the final manuscript.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Lin Yang, MD, Professor, Medical Research Center, Department of Radiology, The Affiliated Hospital of North Sichuan Medical College, No. 63 Wenhua Road, Nanchong 637000, Sichuan Province, China. linyangmd@163.com
Received: November 15, 2021
Peer-review started: November 15, 2021
First decision: December 27, 2021
Revised: January 8, 2022
Accepted: February 23, 2022
Article in press: February 23, 2022
Published online: April 6, 2022
Processing time: 133 Days and 21.2 Hours
Abstract
BACKGROUND

A cervical aortic arch (CAA) refers to a high-riding aortic arch (AA) that often extends above the level of the clavicle. This condition is very rare, with an incidence of less than 1/10000.

CASE SUMMARY

A 29-year-old woman was admitted to the otolaryngology department of our hospital for repeated bilateral purulent nasal discharge for the prior 3 mo. The patient was diagnosed with chronic sinusitis and chronic rhinitis at admission. A preoperative noncontrast chest computed tomography scan showed a high-riding, tortuous AA extending to the mid-upper level of the first thoracic vertebra with local cystic dilatation. A further computed tomography angiography examination showed that the brachiocephalic trunk, left common carotid artery, left vertebral artery (LVA) (slender), and left subclavian artery sequentially branched off of the aorta from the proximal end to the distal end of the AA. The proximal end of the right subclavian artery (RSCA) was tortuous and dilated. The AA showed tumor-like local expansion, with a maximum diameter of approximately 4 cm. After consultation with the department of cardiac macrovascular surgery, the patient was diagnosed with left CAA with aneurysm formation and an anomalous RSCA and LVA and was transferred to that department. The patient underwent AA aneurysm resection and artificial blood vessel replacement under general anesthesia and cardiopulmonary bypass. No abnormality was found during the 2-mo follow-up after discharge.

CONCLUSION

A CAA is a rare congenital anomaly of vascular development. The present unique case of CAA with aneurysm formation and an anomalous RSCA and LVA enriches existing CAA data.

Keywords: Cervical aortic arch; Aortic aneurysm; Aortic anomaly; Computed tomography angiography; Haughton classification; Case report

Core Tip: A cervical aortic arch (CAA) is a rare congenital anomaly of vascular development and refers to a high-riding aortic arch that often extends above the level of the clavicle. This paper reports a case of a unique CAA with aneurysm formation and an anomalous right subclavian artery and left vertebral artery. The present unique case enriches existing CAA data.