Vascular rings and slings

Last revised by Dr Jeremy Jones on 13 Oct 2021

Vascular rings and slings refer to the congenital vascular encirclement of the esophagus and/or trachea by anomalous/aberrant vessels. 

Vascular rings are rare, occurring in <1% of patients 1. No gender or ethnic predispositions have been identified 3

Many vascular rings and slings are asymptomatic although they can present in pediatric patients with wheezing/stridor, recurrent respiratory infections and/or dysphagia lusoria

Vascular rings can be classified as complete (mostly symptomatic) or incomplete (mostly asymptomatic) 5

Causes of vascular rings and slings commonly include 1:

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:

  • allow precise demonstration of the anomaly

Possible considerations include:

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Cases and figures

  • Case 1: fluoroscopy
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  • Case 1: CTA
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  • Case 2: right aortic arch
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  • Case 3: pulmonary sling
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  • Case 4: double aortic arch
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  • Case 5: pulmonary sling
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  • Case 6: with double outlet right ventricle
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