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Persistent Fifth Arch
Suhny Abbara, MD, FACR, FSCCT
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KEY FACTS

  • Terminology

    • Imaging

      • Clinical Issues

        TERMINOLOGY

        • Synonyms

          • Ipsilateral double aortic arch
          • Double lumen aortic arch
        • Definitions

          • Rare congenital vascular anomaly of aortic arch
            • May be isolated
            • Often associated with other congenital cardiac, vascular, or skeletal anomalies
          • 2 distinct forms
            • Systemic-to-systemic connection
              • 5th arch arises at brachiocephalic trunk and reconnects at descending aorta
            • Systemic-to-pulmonary connection
              • 5th arch connects with embryologic remnant of 6th aortic arch, which is usually left pulmonary artery

        IMAGING

        • General Features

          • Radiographic Findings

            • CT Findings

              • MR Findings

                • Imaging Recommendations

                  DIFFERENTIAL DIAGNOSIS

                    CLINICAL ISSUES

                    • Presentation

                      • Demographics

                        • Treatment

                          DIAGNOSTIC CHECKLIST

                          • Consider

                            Selected References

                            1. Kligerman S et al: Persistent fifth aortic arch in a patient with a history of intrauterine thalidomide exposure. J Cardiovasc Comput Tomogr. 3(6):412-4, 2009
                            2. Kirsch J et al: Magnetic resonance angiography of an ipsilateral double aortic arch due to persistent left fourth and fifth aortic arches. Pediatr Radiol. 37(5):501-2, 2007
                            3. Zhao YH et al: Surgical treatment of persistent fifth aortic arch associated with interrupted aortic arch. Ann Thorac Surg. 84(3):1016-9, 2007
                            4. Zhong Y et al: Contrast-enhanced magnetic resonance angiography of persistent fifth aortic arch in children. Pediatr Radiol. 37(3):256-63, 2007
                            5. Hwang MS et al: Isolated persistent fifth aortic arch with systemic-to-pulmonary arterial connection. J Thorac Cardiovasc Surg. 126(5):1643-4, 2003
                            Related Anatomy
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                            Related Differential Diagnoses
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                            References
                            Tables

                            Tables

                            KEY FACTS

                            • Terminology

                              • Imaging

                                • Clinical Issues

                                  TERMINOLOGY

                                  • Synonyms

                                    • Ipsilateral double aortic arch
                                    • Double lumen aortic arch
                                  • Definitions

                                    • Rare congenital vascular anomaly of aortic arch
                                      • May be isolated
                                      • Often associated with other congenital cardiac, vascular, or skeletal anomalies
                                    • 2 distinct forms
                                      • Systemic-to-systemic connection
                                        • 5th arch arises at brachiocephalic trunk and reconnects at descending aorta
                                      • Systemic-to-pulmonary connection
                                        • 5th arch connects with embryologic remnant of 6th aortic arch, which is usually left pulmonary artery

                                  IMAGING

                                  • General Features

                                    • Radiographic Findings

                                      • CT Findings

                                        • MR Findings

                                          • Imaging Recommendations

                                            DIFFERENTIAL DIAGNOSIS

                                              CLINICAL ISSUES

                                              • Presentation

                                                • Demographics

                                                  • Treatment

                                                    DIAGNOSTIC CHECKLIST

                                                    • Consider

                                                      Selected References

                                                      1. Kligerman S et al: Persistent fifth aortic arch in a patient with a history of intrauterine thalidomide exposure. J Cardiovasc Comput Tomogr. 3(6):412-4, 2009
                                                      2. Kirsch J et al: Magnetic resonance angiography of an ipsilateral double aortic arch due to persistent left fourth and fifth aortic arches. Pediatr Radiol. 37(5):501-2, 2007
                                                      3. Zhao YH et al: Surgical treatment of persistent fifth aortic arch associated with interrupted aortic arch. Ann Thorac Surg. 84(3):1016-9, 2007
                                                      4. Zhong Y et al: Contrast-enhanced magnetic resonance angiography of persistent fifth aortic arch in children. Pediatr Radiol. 37(3):256-63, 2007
                                                      5. Hwang MS et al: Isolated persistent fifth aortic arch with systemic-to-pulmonary arterial connection. J Thorac Cardiovasc Surg. 126(5):1643-4, 2003