Double aortic arch anomalies: diagnosis by countercurrent right brachial arteriography

The clinical, radiologic, angiographic, and operative findings in 15 patients with double aortic arch are described. In five patients, both arches were functional; in the other 10, a portion of the left arch was atretic. Depending on the location of the atretic segment, the anomalies were classified into types A, B, and C double aortic arch. We considered an additional type D double aortic arch which as yet remains a theoretical possibility. With the help of refined angiographic signs obtained by countercurrent right brachial angiography and on the basis of clinical and radiologic signs of tracheoesophageal compression, the differential diagnosis among various types of double aortic arch and right aortic arch anomalies was improved.