This was my the first multislice CT for a right aortic arch with aberrant left subclavian arising from a diverticulum of Kommerel. It was the first time I could merge images of the aorta and of the airways and show how the diverticulum is the main point of pressure on the trachea and oesophagus. It was a small bonus to see an anomalous origin of the left apico-posterior bronchus from the left main bronchus. Never seen one before or since.
Later, when I had learnt how to add colour to the models, this man in his twenties presented with pain,pallor and paralysis of the left arm. It had resolved by the time he arrived. Worried about the thoracic inlet or embolus etc, we did a vasular CT and this image shows another aberrant left subclavian with a right aortic arch. Moreover, the aberrant vessel looked dilated so I viewed it from the rear.
And this showed the bulge in the vessel and a pointed projection from it which looked as if it might have been connected to something else in the past. I did wonder if it was an old ductus origin, but it is not quite pointing in the right direction. This would however explain why there is no diverticulm in this case. Finding nothing else, we discharged him. He had another episode, self limiting again, a few months later. I can only surmise that he was getting spasm in the vessel. Why, I know not.