scholarly journals Right-sided aortic arch with anomalous origin of the left subclavian artery: Case report

2011 ◽  
Vol 139 (9-10) ◽  
pp. 666-668 ◽  
Author(s):  
Goran Vucurevic ◽  
Slobodan Tanaskovic ◽  
Nenad Ilijevski ◽  
Vladimir Kovacevic ◽  
Vladimir Kecmanovic ◽  
...  

Introduction. A right-sided aortic arch is a rare congenital defect of the aorta with incidence of 0.05% to 0.1% reported in published series. Usually it is associated with congenital heart anomalies and esophageal and tracheal compression symptoms. We present a case of a right-sided aortic arch of anomalous left subclavian artery origin, accidentally revealed during multislice CT (MSCT) supraaortic branches angiography. Case Outline. A 53-year-old female patient was examined at the Outpatients? Unit of the Vascular Surgery University Clinic for vertigo, occasional dizziness and difficulty with swallowing. Physical examination revealed a murmur of the left supraclavicular space, with 15 mmHg lower rate of arterial tension on the left arm. Ultrasound of carotid arteries revealed 60% stenosis of the left subclavian artery and bilateral internal carotid artery elongation. MSCT angiography revealed a right-sided aortic arch with aberrant separation of the left subclavian artery that was narrowed 50%, while internal carotid arteries were marginally elongated. There was no need for surgical treatment or percutaneous interventions, so that conservative treatment was indicated. Conclusion. A right-sided aortic arch is a very rare anomaly of the location and branching of the aorta. Multislice CT angiography is of great importance in the diagnostics of this rare disease.

2017 ◽  
Vol 31 (3) ◽  
pp. 305-308 ◽  
Author(s):  
Akira Uchino ◽  
Kazuhiko Uwabe ◽  
Iichiro Osawa

Rarely, the external and internal carotid arteries arise separately from the brachiocephalic trunk and right subclavian artery (SA) or the aortic arch and reflect the absence of a common carotid artery (CCA). We report a 45-year-old man with absent right CCA associated with aberrant right SA, an extremely rare combination, diagnosed by computed tomography (CT) angiography during follow-up for postoperative aortic dissection. Retrospective careful observation of preoperative postcontrast CT revealed the absent right CCA. Previously reported arch variations associated with absent CCA include cervical aortic arch, double aortic arch, and right aortic arch.


2018 ◽  
Vol 46 (1) ◽  
pp. 8
Author(s):  
Radan Elvis Matias de Oliveira ◽  
Hélio Norberto De Araújo Júnior ◽  
Herson Da Silva Costa ◽  
Gleidson Benevides De Oliveira ◽  
Carlos Eduardo Bezerra De Moura ◽  
...  

Background: Gerbils (Meriones unguiculatus) are rodents belonging to the Muridae family. Recently, breeding of this species as pets has increased significantly. Animal models are being investigated to study diseases related to the human aortic arch. Despite the importance of the aortic arch in maintaining homeostasis, there is limited data available regarding its morphology in gerbils. This study was performed with the objective of describing the collateral branches of the aortic arch in this animal to establish a standard model and thus contribute to future research on cardiovascular diseases in humans.Materials, Methods & Results: This study used 20 male specimens from previous studies that were frozen and stored at the Laboratory of Veterinary Anatomy of the Federal Rural University of the Semi-Arid Region. After thawing the animals, the thoracic cavity was opened for aortic cannulation. The vascular system was washed using saline solution and Neoprene latex stained with red pigment was injected. Subsequently, the animals were fixed in 10% formaldehyde and were dissected and analyzed 72 h later. The arrangement of the collateral branches of the aortic arch in gerbils was analyzed in all animals. The brachiocephalic trunk, the left common carotid, and the left subclavian artery were observed to originate as collateral branches. The brachiocephalic trunk bifurcated into the right common carotid and the right subclavian arteries. The right and the left subclavian arteries branched into the vertebral artery, the internal thoracic artery, the superficial cervical artery, the costocervical trunk, and the axillary artery.Discussion: Several studies reported in the literature describe the collateral branches of the aortic arch in domestic and wild mammalian species. These studies examined the main arteries that originate directly from the aortic arch and their respective branches, and classified the different anatomical variants of the aortic arch in each species. Three different arrangements have been commonly described. The first type corresponds only to the brachiocephalic artery originating from the aortic arch. The right and the left common carotid arteries and the right and the left subclavian arteries originate from this brachiocephalic artery. This type has already been described in the laboratory rat, catingueiro-deer, cattle, and horses. The second type is characterized by the presence of 2 arteries - the brachiocephalic trunk and the left subclavian artery. The right and the left common carotid arteries and the right subclavian artery originate from the brachiocephalic trunk. This arrangement has been reported in most species already studied such as rodents including the paca, chinchilla, guinea pig, mocó, nutria and the preá. The third type of vascular arrangement is observed in the gerbil. In this species, 3 collateral arteries originate from the aortic arch (the brachiocephalic trunk, the left common carotid, and the left subclavian artery). The right common carotid and the right subclavian artery originate from the brachiocephalic trunk. This vascular model has been described in the manatee, in humans, mice, sauim, and the monkey-nail. Thus, we concluded that the branching pattern of the aortic arch of the gerbil was characterized by the brachiocephalic trunk, the left common carotid, and the left subclavian artery, as has been described in mice, the manatee, monkey-nail, sauim, and humans. Based on these morphological characteristics, gerbils could serve as potential experimental models to study diseases related to the human aortic arch.


Vascular ◽  
2005 ◽  
Vol 13 (5) ◽  
pp. 298-300 ◽  
Author(s):  
Nicola Mangialardi ◽  
Pierluigi Costa ◽  
Eugenia Serrao ◽  
Carlo Cavazzini ◽  
Patrice Bergeron

Endovascular treatment of aortic arch aneurysms poses unique problems because of vascularization of the carotid arteries. Transposition of supra-aortic vessels is becoming an established and accepted strategy for expanding the applicability of stent graft repair. left subclavian artery (LSA) is not usually transposed because its overstenting does not produce relevant complications. Nevertheless, some selected cases need high-pressure revascularization of the LSA, such as in the presence of a patent left internal mammary artery. We present a technique of revascularization of supra-aortic vessels and “balloon protected” embolization of the origin of the LSA.


Author(s):  
Novikova I.N. ◽  
Popova T.F. ◽  
Gribacheva I.A. ◽  
Petrova E.V. ◽  
Marushchak A.A. ◽  
...  

Moya-Moya disease is a rare progressive chronic cer-ebrovascular disease characterized by a narrowing of the lumen of the intracranial segments of the internal carotid arteries, as well as the initial segments of the anterior and middle cerebral arteries with the devel-opment of a network of small vascular anastomoses. Violations of blood supply due to occlusion lead to the development of ischemic strokes in the correspond-ing pools, and ruptures of vascular anastomoses - to the development of hemorrhagic strokes, causing a variety of neurological disorders. The article presents a clinical case of Moya-Moya disease in a 31-year-old patient. The disease was manifested by acute disorders of cerebral circulation in ischemic and hemorrhagic types. The diagnosis was made in accordance with the diagnostic criteria of the disease based on the data of endovascular cerebral angiography.


2001 ◽  
Vol 176 (1) ◽  
pp. 263-264 ◽  
Author(s):  
Rodolfo A. Ibarra ◽  
Prabhakar Kesava ◽  
John L. Fewins

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1119.3-1120
Author(s):  
L. Nacef ◽  
H. Ferjani ◽  
H. Riahi ◽  
Y. Mabrouk ◽  
E. Labbene ◽  
...  

Background:Patients with rheumatoid arthritis (RA) are at higher cardiovascular risk (CVR) than the general population due to chronic inflammation. Several factors, both modifiable and non-modifiable, can increase this risk. Intima-media thickness (IMT) was considered as a marker for atherosclerosis.Objectives:This study aimed to identify predictor factors of increasing IMT.Methods:The prospective study was carried out on patients with RA who met the 2010 American College of Rheumatology (ACR)/European League Against Rheumatism (EULAR) classification criteria. These patients were followed in the rheumatology department of the Kassab Institute. The socio-demographic data, biological and immunological parameters were collected.Framingham’s score quantified the cardiovascular risk at 10-years. Carotid Ultrasonography (US) using a high resolution B mode carotid measured intima-media thickness (IMT) as a subclinical marker of atherosclerosis. Carotid US was performed in the supine position, according to American Society of Echocardiography guidelines. IMT was measured in the left (LCC) and right (RCC) common carotid arteries, the left (LIC) and right (RIC) internal carotid arteries, and the left (LEC) and right (RIC) internal carotid arteries. An increased IMT was defined as ≥0.9 mm.We analyzed data by the SPSS statistical package. A p-value <0.05 was considered significant.Results:Of the 47 patients surveyed, 78.7% were female. The mean age was 52.5 ±11.06 [32-76]. The duration disease was 86.25 ±63 months [5-288] and was erosive in 81.6% of cases. The rheumatoid factor (RF) was positive in 57.8% of patients, and citrullinated antipeptide antibodies (ACPA) were present in 62.2%. Eight patients had a previous CV history (hypertension, diabetes or dyslipidemia) and 16.4% were active smokers. Among women, 43.6% were postmenopausal. ITM was significantly higher in men at LIC (0.037) and LEC (0.025). Older age was associated with increased ITM in LIC (p=0.046; r=0.295), LEC (p=0.05; r=0.412), RCC (p=0.034; r=0.317), and REC (p=0.009; r=0.382). The ITM for LCC, LIC, LEC, RCC, RIC, and REC was higher in postmenopausal women, with no significant difference (p=0.782, p=0.208, p=0.877, r=0.734, p=0.808, p=0.437, respectively).Among the modifiable factors, active smoking was associated with a higher ITM at the REC level (p=0.047). However, weight was not associated with an increased ITM (LCC: p=0.092; LIC: p=0.985; LEC: p=0.952; RCC: p=0.744; RIC: p=0.210; REC: p=0.510). In our study, there was no significant association between DAS28 disease activity or inflammatory marks and ITM (LCC: p=0.784; LIC: p=0.316; LEC: p=0.420; RCC: p=0.784; RIC: p=0.484; REC: p=0.754).Conclusion:In our study, the non-modifiable factors associated with increased ITM were advanced age and male gender. The modifiable factor impacting ITM was primarily active smoking. Surprisingly, disease activity and biological inflammation did not influence ITM.References:[1]S. Gunter and al. Arterial wave reflection and subclinical atherosclerosis in rheumatoid arthritis. Clinical and experimental rheumatology 2018; 36: clinical e.xperimental.[2]Aslan and al. Assessment of local carotid stiffness in seronegative and seropositive rheumatoid Arthritis. Scandinavian cardiovascular journal, 2017.[3]Martin i. Wah-suarez and al, carotid ultrasound findings in rheumatoid arthritis and control subjects: a case-control study. Int j rheum dis. 2018;1–7.Disclosure of Interests:None declared


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