scholarly journals An unusual origin of the right subclavian artery – arteria lusoria

2014 ◽  
Vol 27 (4) ◽  
pp. 234-236
Author(s):  
Agnieszka Mocarska ◽  
Miroslaw Szylejko ◽  
Elzbieta Staroslawska ◽  
Franciszek Burdan

Abstract The aortic arch usually gives off three major arterial branches: the brachiocephalic trunk, the left common carotid artery and the left subclavian artery. The most frequently occurring developmental variations of arterial trunks origins are a joined brachiocephalic and left common carotid artery origin, the left vertebral artery branching from the aortic arch, a double aortic arch, and a change of sequence of branching arteries. The current report presents the rare asymptomatic situation of the right subclavian artery originating as the last individual branching from the aortic arch. This abnormality was accidentally discovered in a computed tomography examination of a 69-year old male patient. The examination showed that the artery went towards the neck posteriorly from the trachea. The anatomical anomaly was interpreted as being an arteria lusoria.

ISRN Anatomy ◽  
2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Virendra Budhiraja ◽  
Rakhi Rastogi ◽  
Vaishali Jain ◽  
Vishal Bankwar ◽  
Shiv Raghuwanshi

Variations of the branches of aortic arch are due to alteration in the development of certain branchial arch arteries during embryonic period. Knowledge of these variations is important during aortic instrumentation, thoracic, and neck surgeries. In the present study we observed these variations in fifty-two cadavers from Indian populations. In thirty-three (63.5%) cadavers, the aortic arch showed classical branching pattern which includes brachiocephalic trunk, left common carotid artery, and left subclavian artery. In nineteen (36.5%) cadavers it showed variations in the branching pattern, which include the two branches, namely, left subclavian artery and a common trunk in 19.2% cases, four branches, namely, brachiocephalic trunk, left common carotid artery, left vertebral artery, and left subclavian artery in 15.3% cases, and the three branches, namely, common trunk, left vertebral artery, and left subclavian artery in 1.9% cases.


2021 ◽  
Vol 25 (3) ◽  
pp. 83
Author(s):  
V. A. Mironenko ◽  
V. S. Rasumovsky ◽  
A. A. Svobodov ◽  
S. V. Rychin

<p>We herein report the first clinical case of prosthetic replacement of the ascending aorta and aortic arch to repair a giant aneurysm in a 7-month-old child. The ascending aorta and arch replacement to the level of left subclavian artery was performed using a no. 16 Polymaille prosthesis, the brachiocephalic trunk was reimplanted into the vascular prosthesis and the kinked section of the left common carotid artery was removed, followed by reimplanting the left common carotid artery into the left subclavian artery. First, proximal anastomosis with the vascular prosthesis was created using a no. 16 Polymaille prosthesis and the vascular suture was strengthened with a Teflon strip. During circulatory arrest, the aortic arch was crossed between the orifice of the left common carotid artery and left subclavian artery, with the cut extended to the isthmus region along the small curvature of the arch. The brachiocephalic trunk was aligned and brought down, with subsequent implantation into the ascending aorta prosthesis 2 cm below the initial fixation point. In the final stage, the kinked section of the left common carotid artery was resected and the aligned left carotid artery was directly reimplanted into the left subclavian artery using end-to-side anastomosis. The patient developed tracheobronchitis and moderate heart failure during the postoperative period. The duration of mechanical ventilation was 16 hours. Infusion and antibacterial therapy were discontinued on postoperative day 8. On postoperative day 13, the patient was discharged and referred to the outpatient centre for further treatment and rehabilitation. A sufficiently large-sized prosthesis allows for further development in paediatric patients. This is facilitated by the preservation of the native aortic root with restored valve function and the formation of a bevelled distal anastomosis with a small unchanged aortic section in the isthmus region, which maintains growth potential. This first reported case of an infant demonstrates the possibility of combination interventions on the aortic arch and brachiocephalic artery during the first year of life.</p><p>Received 30 January 2021. Revised 24 March 2021. Accepted 29 March 2021.</p><p><strong>Funding:</strong> The study did not have sponsorship.</p><p><strong>Conflict of interest:</strong> The authors declare no conflicts of interests.</p><p><strong>Contribution of the authors: </strong>The authors contributed equally to this article.</p>


2004 ◽  
Vol 10 (4) ◽  
pp. 309-314 ◽  
Author(s):  
P.A. Brouwer ◽  
M.P.S. Souza ◽  
R. Agid ◽  
K.G. terBrugge

In this case presentation we describe a patient with an anomalous origin of the right vertebral artery arising from the right common carotid artery in combination with an aberrant right subclavian artery and a left vertebral artery originating from the arch between the left common carotid artery and left subclavian artery. Hence there were five vessels originating from the aortic arch. The possible embryological mechanism as well as a postulation on the importance of the level of entrance of the vertebral artery in the cervical transverse foramen is discussed.


2013 ◽  
Vol 19 (3) ◽  
pp. 154-159 ◽  
Author(s):  
A.M. Manole ◽  
D.M. Iliescu ◽  
A. Rusali ◽  
P. Bordei

Abstract Our study was conducted by the evaluation of angioCT’s performed on a GE LightSpeed VCT64 Slice CT Scanner. The measurements were performed on the aortic arch at the following levels: at the origin of the aorta, the middle part of the ascending aorta, prior to the origin of the brachiocephalic arterial trunk and after the origin of the left subclavian artery. We measured the caliber of the aortic arch arteries and the data are correlated and reported by gender. The diameter of the ascending aorta was between 27 to 28.9 mm in females and in males from 25.8 to 37.6 mm. The diameter of the aorta within the middle segment of the ascending part was between 28-30.2 mm in females and in males from 26.1 to 34.6. The diameter of the aortic arch prior to the origin of the brachiocephalic arterial trunk was between 26.4 to 29.4 mm in females and in males from 25.8 to 37.5 mm. The diameter of the aortic arch after the origin of the left subclavian artery was in a range of 20.4 to 28.4 mm, which corresponds to the limits found in males while in females the aortic diameter was between 21.3 to 24.1 mm. The brachiocephalic trunk diameters were 8.3 to 15.5 mm in females and in males was 9.1 to 14.5 mm. The right common carotid artery had a diameter of 4-8 mm diameter in males and in females ranged from 4.7 to 5.5 mm. The right subclavian artery showed a caliber of 5.7 to 7.5 mm in females and in males from 5.9 to 10.1. The left common carotid artery diameter was 4.6 to 5.7 mm in females and males the diameter was between 5.2 to 7.4 mm. The left subclavian artery had a diameter of 6-10 mm in females and in males ranged from 7.7 to 12.8 mm. We found that the distance between the ascending part of the aorta and the descending segment ranged from 33.3 to 38.5 mm in females and in males from 40 to 68.6 mm. We measured the distance that exists at the crossing of the aortic arch with the left branch of the pulmonary trunk, finding that in females this distance is 3 to 10.3 mm and in males from 3 to 12.5 mm.


2011 ◽  
Vol 56 (No. 3) ◽  
pp. 131-134 ◽  
Author(s):  
A. Aydin

This study had the aim of investigating the anatomy of the aortic arch in squirrels (Sciurus vulgaris). Ten squirrels were studied. The materials were carefully dissected and the arterial patterns of arteries originating from the aortic arch were examined. The brachiocephalic trunk and the left subclavian artery were detached from the aortic arch. The brachiocephalic trunk first gave the left common carotid artery, and then detached to the right subclavian and common carotid artery. In all the examined materials, the left and right subclavian arteries gave branches that were similar after leaving the thoracic cavity from the cranial thoracic entrance. But while the whole branches of the the right subclavian artery were arising from almost the same point the left subclavian artery gave these branches in a definite order, and the branches that separated were the following: the internal thoracic artery, the intercostal suprema artery, the ramus spinalis, the vertebral artery and the descending scapular artery. It also gave the common branch formed by the junction of three of the cervical superficial, the cevical profund and the suprascapular arteries. After the separation of these branches, continuation of the artery gave the external thoracic artery on the external face of the thoracic cavity and then formed the axillar artery. The axillary artery separated into the subscapular and the brachial arteries. Thus, the arteries originating from the aortic arch and the branches of these arteries are different from other rodents and from domestic mammals.


Author(s):  
Barbara Buffoli ◽  
Vincenzo Verzeletti ◽  
Lena Hirtler ◽  
Rita Rezzani ◽  
Luigi Fabrizio Rodella

AbstractA rare branching pattern of the aortic arch in a female cadaver is reported. An aberrant right subclavian artery originated from the distal part of the aortic arch and following a retroesophageal course was recognized. Next to it, from the left to the right, the left subclavian artery and a short bicarotid trunk originating the left and the right common carotid artery were recognized. An unusual origin of the vertebral arteries was also identified. The left vertebral artery originated directly from the aortic arch, whereas the right vertebral artery originated directly from the right common carotid artery. Retroesophageal right subclavian artery associated with a bicarotid trunk and ectopic origin of vertebral arteries represents an exceptional and noteworthy case.


Author(s):  
Amanjeet S. Kindra ◽  
Suneel K. Gupta

The Vertebral Artery (VA) is classically described as originating as the first branch of the ipsilateral subclavian artery. The VA origin is variable and has been identified at the aortic arch, Common Carotid Artery (CCA), and Internal Carotid Artery. The VA arising from the carotid artery is an extremely uncommon variant. Left VA origin from the left CCA has been reported only thrice. These rare anomalous origins of the VA usually are asymptomatic. We describe symptomatic aberrant origin of left vertebral artery from left common carotid artery, a rare case.


2004 ◽  
Vol 9 (2) ◽  
Author(s):  
A.L.Q. SANTOS ◽  
F.M. MORAES ◽  
T.S. MALTA ◽  
S.F.M. CARVALHO ◽  
J.R.F. ALVES JUNIOR

Estudou-se a topografia dos colaterais calibrosos do arco aórtico em um exemplar de Procyon cancrivorus, adulto, macho, proveniente da Fazenda Experimental do Glória, da Universidade Federal de Uberlândia, MG, Brasil, o qual teve seus vasos arteriais injetados com solução corada de Neoprene Latex “450”, com posterior fixação em solução aquosa de formol a 10% e submetidos à dissecação. O arco aórtico encontra-se em correspondência à terceira costela, no antímero esquerdo da cavidade torácica. O primeiro ramo calibroso do arco aórtico é o tronco braquiocefálico, situado medialmente à terceira costela, originando as artérias carótida comum esquerda, carótida comum direita e a subclávia direita, em correspondência ao primeiro espaço intercostal. A artéria subclávia esquerda é o segundo ramo emergente do arco aórtico, originando-se medialmente à terceira costela. As artérias subclávias direita e esquerda, cedem os mesmos colaterais em ambos os antímeros, ou seja, tronco costocervical esquerdo (medialmente à primeira costela), tronco costocervical direito (borda cranial da primeira costela), artérias cervical superficial esquerda e cervical superficial direita (borda cranial da primeira costela), artéria torácica interna esquerda (medialmente à segunda costela) e artéria torácica interna direita (borda cranial da primeira costela). The topography of the thick collaterals of the aortic arch in a crab – eating raccoon Procyon cancrivorus – Gray, 1865, Carnivora – Procyoniadae Abstract An anatomical study has been carried out on the topography of the thick collateral branches of the aortic arch in an adult male specimen of raccoon (Procyon cancrivorus) from the Gloria Experimental Farm, Federal University of Uberlandia MG, Brasil. For this purpose, the arterial blood vessels were injected with a ruddy solution of Neoprene Latex “450”, fixed by means of a 10% aqueous solution of formaldehyde and then dissected. It has been observed that the aortic arch is in correspondence with the third rib at the left side of the thoracic cavity The first thick branch of the aortic arch is the brachiocephalic trunk which is situaded medially in regard to the third rib, originating the left common carotid artery, the right common carotid artery and the right subclavian artery in correspondence with the first intercostal space. The left subclavian artery is the second emerging branch of the aortic arch originating itself medialy to the third rib. The right and the left subclavian arteries give way to the same collaterals in both sides, as the left costocervical trunk (medially to the first rib), the right costocervical trunk (cranial edge of the first rib), the left and the right superficial cervical arteries (cranial edge of the first rib, the left internal thoracic artery (medially to the second rib), and the right internal thoracic artery (cranial edge of the first rib).


2018 ◽  
Vol 46 (1) ◽  
pp. 6
Author(s):  
Cristian Martonos ◽  
Radu Lăcătuș ◽  
Daniel Cocan ◽  
Florin Stan ◽  
Aurel Damian ◽  
...  

Background: The investigation on the cardiocirculatory system in chinchilla has become increasingly important due to the use of the species in experimental medicine (toxicology, pathology, parasitology etc.). Even though initially this species was regarded with a strict economic interest, in the last period, chinchillas have become an increasingly-encountered patient in veterinary clinics and hospitals. Another aspect is the use of the species in medical research, as experimental model or in parasitology. The present study tackles a combined anatomical and radiological (angiographical) study to accurately describe the vascular anatomy of the initial part of the aortic arch (Arcus aortae).Materials, Methods & Results: The anatomical distribution of collaterals detached from arcus aorticus (brachiocephalic trunk and subclavian arteries) are highlighted in this paper. To do that, the classical stratigraphic anatomical investigation, followed by the radiological study with the help of the contrast substance injected into the vascular bed were used in combination. Several Chinchilla lanigera female carcasses, obtained from a private commercial farming unit in Cluj county, Romania were used for this study. Ten carcasses were used for the anatomical study, being injected into the vascular bed with a mixture of latex and acrylic dye, fixated into formaldehyde 5% and later dissected, while the other ten carcasses were injected at the level of the aortic arch with Visipaque 320 contrast substance and subjected to the angiographical procedure.The anatomical investigation was carried after an initial 5 day-fixation period, while the angiographic procedure was initiated using the TEMCO Grx-01 device and the Veterinary Digital Imaging System® as digital imaging processing software. This combined study shows the differential mode of emergence of the subclavian and carotid arteries in this species. The brachiocephalic trunk is the first large collateral branch arising from the initial part of the aortic cross while the left subclavian artery, in all studied cases, stems from this initial part of the aortic arch. The right subclavian artery arises from the terminal part of the brachiocephalic trunk, at the cranial border of the first rib. The continuation of the trunk is represented by right common carotid artery that follows the right jugular groove. The left common carotid artery emerges at the medial aspect of the first intercostal space as a collateral branch detached from the brachiocephalic trunk, in its initial sector. In respect to the collaterals emerging from the subclavian arteries, our study showed that in all studied cases, four branches arise in sequence- the internal thoracic, dorsal scapular, vertebral and superficial cervical arteries. The existence of the common trunks (internal thoracic, dorsal scapular arteries and superficial and deep cervical arteries (as described by other authors) was not confirmed on the investigated specimens.Discussion: The paper highlights some interesting facts referring to the specific morphology of the aortic arch in chinchilla, as literature data provides some divergent data. Some of the aspects noted are confirmed (the emergence of subclavian arteries) while some others are still subjects to discussion and further investigation (collateral branches of subclavian arteries). Our approach focuses also on the comparative aspects of the morphology of the branches emerging from the aortic arch. According to the available literature, the following species were used as comparison: leporids, Guinea pig, squirrel, yellow-necked mouse, Egyptian mouse, rat, armadillo, nutria, capybara, paca, fox and leopard.


2020 ◽  
Vol 24 (4) ◽  
pp. 72
Author(s):  
A. A. Shadanov ◽  
D. A. Sirota ◽  
T. A. Bergen ◽  
M. M. Lyashenko ◽  
A. M. Chernyavskiy

<p><strong>Aim.</strong> Assessment of normal and variant aortic arch anatomy in patients with type A aortic dissection and aneurysm of the arch and descending thoracic aorta.</p><p><strong>Methods.</strong> We retrospectively studied computer tomography (CT) data of chest organs with contrast in patients who underwent reconstruction of the aortic arch in type I aortic dissection according to DeBakey classification (n = 61) and resection of the aortic arch and descending thoracic aorta aneurysm (n = 14) at the Meshalkin National Medical Research Center, Novosibirsk, Russian Federation. The control group included patients without aortic arch pathology (n = 52). To identify relationships between the anatomical type of aortic arch and the risk of aortic pathology development, univariate and multivariate binary logistic regression analyses were used.</p><p><strong>Results.</strong> Our analysis revealed four types of aortic arch anatomy. Normal aortic arch anatomy occurred in 66.1 % of patients (n = 84), the proportion of abnormalities of the left common carotid artery was 30 % (bovine aortic arch occurred in 15 %, and the same site of origin of left common carotid artery and brachiocephalic trunk occurred in 15 %). Divergence of the left vertebral artery from the aortic arch between the left common carotid and left subclavian arteries occurred in 3.1 % (n = 4), and the combination of “bovine trunk” and divergence of the left vertebral artery from the aortic arch was detected in 0.8 % patients (n = 1). Logistic regression analyses revealed no statistically significant relationships between variant aortic arch anatomy and the development of type A aortic dissections and aortic arch aneurysms. The presence of the common origin of brachiocephalic trunk and left common carotid artery was associated with a reduced risk of acute aortic dissection type I by 89 %, or an OR of 0.11 (95% CI: 0.03–0.46) (p = 0.002).</p><p><strong>Conclusion.</strong> Our data will help with future planning surgical interventions on the aortic arch and descending thoracic aorta.</p><p>Received 17 June 2020. Revised 16 July 2020. Accepted 17 July 2020.</p><p><strong>Funding:</strong> The study did not have sponsorship.</p><p><strong>Conflict of interest:</strong> Authors declare no conflict of interest.</p><p><strong>Author contributions</strong><br />Conception and design: A.A. Shadanov<br />Data collection and analysis: A.A. Shadanov, T.A. Bergen<br />Statistical analysis: D.A. Sirota, A.A. Shadanov<br />Drafting the article: A.A. Shadanov<br />Critical revision of the article: D.A. Sirota, M.M. Lyashenko, A.M. Chernyavskiy<br />Final approval of the version to be published: A.A. Shadanov, D.A. Sirota, T.A. Bergen, M.M. Lyashenko, A.M. Chernyavskiy</p>


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