A case of severe bronchial stenosis caused by a vascular ring in an elderly woman

We report a case of bilateral severe bronchial stenosis which was caused by compression by ascending and descending portions of the aorta. Asthma-like symptoms developed 9 years previously and dilation of the ascending aorta was noted 2 years previously. Bronchial obstruction was suspected because of diminishing breath sounds in the left hemithorax. Investigations suggested existence of a vascular ring consisting of the left aortic arch, right descending aorta and possibly the right ligamentum arteriosum. The patient fell in shock during bronchoscopy. Emergency implantations of bronchial stents in the right bronchus and then the left bronchus were made. Because of the patient's poor lung function, there was an extremely high risk for surgical treatment. Although airway stenosis caused by vascular anomaly in elderly patients is very rare, when asthma-like symptoms developed in patients with a right-sided descending aorta, physicians should consider the possibility of such condition.