A case of double aortic arch accompanied by sub-aortic and pre-aortic left brachiocephalic veins and anomalous origin and course of left vertebral artery

During the elective course of human dissection at the University of Toyama in 2007, we encountered a rare case of double aortic arch accompanied by sub- and pre-aortic left brachiocephalic veins (LBV), and anomalous origin and course of the left vertebral artery in a Japanese elderly female. The double aortic arch formed a complete vascular ring that encircled the trachea and the esophagus. The sub-aortic LBV traversed below the aortic arches between the ascending aorta and the trachea. In addition, there was a small pre-aortic LBV passing anterior to the origins of the aortic arches. The left vertebral artery originated from the left aortic arch and entered the transverse foramen of C3, while the right vertebral artery originated from the right subclavian artery and entered the transverse foramen of C6.