Morphological characteristics of the aortic arch organization

Abstract Our study was performed on 228 cases by dissection, by plastic injection followed by corrosion or dissection and by simple and CT angiography study. Each morphological aspect was assessed on a different numbers of cases, as long as the same case could not provide data on all studied elements. We assessed: the number of branches that originate from the aortic arch, the level of origin and the morphological type of the aortic arch. In terms of number of branches emerging from the aortic arch, most commonly are three branches, in 48.48% of cases, describing them 3 variations: separation of the three classical branches in 45,96% of cases, in 1.51% of cases the left common carotid artery emerged from the brachiocephalic trunk while the other two branches being represented by a vertebral artery and the left subclavian and in 1.01% by the right subclavian artery with retroesophageal traject, by a bicarotid arterial trunk and the left subclavian artery. In 28.70% of the cases were four branches, as follows: in 13.13% of cases the fourth branch was represented by the left vertebral artery, in 7.07% of cases there was the inferior thyroid artery, in 4.04% of cases the brachiocephalic arterial trunk was missing and the right subclavian artery originate from the aortic arch and presented a retroesophageal traject, in 3.03% of cases the fourth artery was the ascending cervical and in 1.51% of cases all four arteries had their origins in the aortic arch with no brachiocephalic trunk. In 22.73% of cases from the aortic arch originated only two branches: in 19.70% of cases the left common carotid originated in the brachiocephalic trunk, so the second branch was the left subclavian and in 3.03% of the cases there were two brachiocephalic trunks. Regarding the level of origin from the aortic arch, we found that only the brachiocephalic arterial trunk showed versions of origin: in 64 61% of the cases the brachiocephalic trunk had its origin in the horizontal segment of the aortic arch, in 21.54% of cases the origin was located at the limit between the ascending and horizontal segments and vin 12.31% of cases the origin was from the ascending segment of the aortic arch. In only 1.54% of the cases the left subclavian artery originated from the descending segment of the aortic arch

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Anatomical Variations in the Branching Pattern of Human Aortic Arch: A Cadaveric Study from Central India

ISRN Anatomy ◽

10.5402/2013/828969 ◽

2013 ◽

Vol 2013 ◽

pp. 1-5 ◽

Cited By ~ 4

Author(s):

Virendra Budhiraja ◽

Rakhi Rastogi ◽

Vaishali Jain ◽

Vishal Bankwar ◽

Shiv Raghuwanshi

Keyword(s):

Carotid Artery ◽

Vertebral Artery ◽

Aortic Arch ◽

Subclavian Artery ◽

Common Carotid Artery ◽

Left Subclavian Artery ◽

Left Vertebral Artery ◽

Common Trunk ◽

Branching Pattern ◽

Brachiocephalic Trunk

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.

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Morphometry of the aortic arch and its branches

ARS Medica Tomitana ◽

10.2478/arsm-2013-0027 ◽

2013 ◽

Vol 19 (3) ◽

pp. 154-159 ◽

Cited By ~ 1

Author(s):

A.M. Manole ◽

D.M. Iliescu ◽

A. Rusali ◽

P. Bordei

Keyword(s):

Carotid Artery ◽

Aortic Arch ◽

Subclavian Artery ◽

Common Carotid Artery ◽

Left Subclavian Artery ◽

Ascending Aorta ◽

Ct Scanner ◽

Arterial Trunk ◽

Brachiocephalic Trunk ◽

The Right

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.

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Fourth branch of arch of aorta and its clinical implication

Journal of Biomedical Sciences ◽

10.3126/jbs.v2i3.14765 ◽

2016 ◽

Vol 2 (3) ◽

pp. 24-27

Author(s):

Rashmi N Gitte ◽

Chenna Reddy Ganji ◽

Vishal M Salve

Keyword(s):

Vertebral Artery ◽

Aortic Arch ◽

Subclavian Artery ◽

Left Vertebral Artery ◽

Branching Pattern ◽

Human Beings ◽

Vertebral Arteries ◽

Brachiocephalic Trunk ◽

Great Vessels ◽

The Right

In human beings the most common branching pattern of the aortic arch was its division into three great vessels ie the brachiocephalic trunk, left common carotid artery and the subclavian artery. The vertebral arteries arise from the superior aspect of the first part of the subclavian artery. In present case, a left vertebral artery arose from the aortic arch as fourth branch was found. The diameter of left vertebral artery at its origin was 6 mm as compared to the right vertebral artery, which has diameter of 3.5 mm at its origin. In this case left sixth dorsal intersegmental artery might have persisted as first part of vertebral artery hence left vertebral artery arising from arch of aorta. Knowledge of the variations in branching pattern of the aortic arch is important in the diagnosis of intracranial aneurysm after subarachnoid haemorrhage.J. Biomed. Sci. 2015, 2(3):21-23.

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An unusual origin of the right subclavian artery – arteria lusoria

Current Issues in Pharmacy and Medical Sciences ◽

10.1515/cipms-2015-0022 ◽

2014 ◽

Vol 27 (4) ◽

pp. 234-236

Author(s):

Agnieszka Mocarska ◽

Miroslaw Szylejko ◽

Elzbieta Staroslawska ◽

Franciszek Burdan

Keyword(s):

Carotid Artery ◽

Aortic Arch ◽

Subclavian Artery ◽

Common Carotid Artery ◽

Left Common Carotid Artery ◽

Left Vertebral Artery ◽

Anatomical Anomaly ◽

Arteria Lusoria ◽

Brachiocephalic Trunk ◽

The Right

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.

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A Five-Vessel Aortic Arch with an Anomalous Origin of Both Vertebral Arteries and an Aberrant Right Subclavian Artery

Interventional Neuroradiology ◽

10.1177/159101990401000404 ◽

2004 ◽

Vol 10 (4) ◽

pp. 309-314 ◽

Cited By ~ 9

Author(s):

P.A. Brouwer ◽

M.P.S. Souza ◽

R. Agid ◽

K.G. terBrugge

Keyword(s):

Carotid Artery ◽

Vertebral Artery ◽

Aortic Arch ◽

Subclavian Artery ◽

Common Carotid Artery ◽

Anomalous Origin ◽

Aberrant Right Subclavian Artery ◽

Left Vertebral Artery ◽

Transverse Foramen ◽

The Right

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.

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Collateral Arteries of the Aortic Arch in Mongolian Gerbil (Meriones unguiculatus)

Acta Scientiae Veterinariae ◽

10.22456/1679-9216.89371 ◽

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 ◽

...

Keyword(s):

Aortic Arch ◽

Subclavian Artery ◽

Carotid Arteries ◽

Left Subclavian Artery ◽

Meriones Unguiculatus ◽

Brachiocephalic Artery ◽

Collateral Arteries ◽

Brachiocephalic Trunk ◽

The Right ◽

Common Carotid Arteries

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.

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The arteries originating from the aortic arch and the branches of these arteries in red squirrels (Sciurus vulgaris)

Veterinární Medicína ◽

10.17221/3158-vetmed ◽

2011 ◽

Vol 56 (No. 3) ◽

pp. 131-134 ◽

Cited By ~ 1

Author(s):

A. Aydin

Keyword(s):

Carotid Artery ◽

Aortic Arch ◽

Subclavian Artery ◽

Common Carotid Artery ◽

Left Subclavian Artery ◽

Axillary Artery ◽

Thoracic Cavity ◽

Sciurus Vulgaris ◽

Brachiocephalic Trunk ◽

The Right

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.

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Retroesophageal right subclavian artery associated with a bicarotid trunk and an ectopic origin of vertebral arteries

Surgical and Radiologic Anatomy ◽

10.1007/s00276-021-02746-1 ◽

2021 ◽

Author(s):

Barbara Buffoli ◽

Vincenzo Verzeletti ◽

Lena Hirtler ◽

Rita Rezzani ◽

Luigi Fabrizio Rodella

Keyword(s):

Carotid Artery ◽

Vertebral Artery ◽

Aortic Arch ◽

Subclavian Artery ◽

Common Carotid Artery ◽

Distal Part ◽

Aberrant Right Subclavian Artery ◽

Left Vertebral Artery ◽

Vertebral Arteries ◽

The Right

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.

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Carotid-Vertebral or Carotid-Subclavian Transpositions in Supra-Aortic Steno-Occlusive Diseases When Endovascular Therapy Is Unfeasible or Unsuccessful

International Surgery ◽

10.9738/intsurg-d-17-00097.1 ◽

2021 ◽

Vol 105 (1-3) ◽

pp. 455-463

Author(s):

Jian Wang ◽

Jie Chu ◽

Lihua Zhang ◽

Juan Chen ◽

Yi Zheng ◽

...

Keyword(s):

Carotid Artery ◽

Endovascular Treatment ◽

Vertebral Artery ◽

Subclavian Artery ◽

Endovascular Intervention ◽

Treatment Modalities ◽

Left Vertebral Artery ◽

Severe Stenosis ◽

Brachiocephalic Trunk ◽

The Right

Background and purpose Despite advances in endovascular therapies, some patients experience vertebral artery stenosis or subclavian artery occlusion and may not benefit from less-invasive angioplasty/stenting. This study described 4 cases in which carotid-vertebral transposition (CVT) or carotid-subclavian transposition (CST) was adapted when endovascular treatment was unfeasible or unsuccessful. Presentation Case 1: A 65-year-old woman presented with severe stenosis of the right vertebral artery ostium, dysplastic left vertebral artery, and aneurysmal dilatation of proximal right subclavian artery and brachiocephalic trunk. Case 2: A 23-year-woman had severe stenosis at the first portion of left vertebral artery caused by Takayasu's arteritis. Because endovascular intervention was unfeasible, CVTs were performed in cases 1 and 2. Case 3: A 73-year-old man presented with total occlusion of the proximal right subclavian artery and severe stenosis of the right internal carotid artery. Case 4: A 58-year-old man experienced complete occlusion of the left subclavian artery and severe stenosis of the left common carotid artery. Duplex ultrasonography showed reverse flow in the vertebral artery in keeping with vertebral steal syndrome. Endovascular treatment was unsuccessful because the wire did not cross the occlusion of the subclavian artery. CSTs were performed with concurrent ipsilateral carotid endarterectomy in cases 3 and 4. Conclusion The present case series demonstrated that CST and CVT were effective treatment modalities for subclavian or vertebral artery lesions. Although endovascular stenting and angioplasty have been advocated as first-line management, CST and CVT should be considered as the remedy when endovascular intervention is unsuccessful or unfeasible.

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Variations in the Branching Pattern of the Aortic Arch Detected with Computerized Tomography Angiography

Advances in Radiology ◽

10.1155/2014/969728 ◽

2014 ◽

Vol 2014 ◽

pp. 1-6 ◽

Cited By ~ 12

Author(s):

Pasaoglu Lale ◽

Ugur Toprak ◽

Gökhan Yagız ◽

Tunca Kaya ◽

Sadık Ahmet Uyanık

Keyword(s):

Aortic Arch ◽

Ct Angiography ◽

Subclavian Artery ◽

Left Subclavian Artery ◽

Right Aortic Arch ◽

Aberrant Right Subclavian Artery ◽

Left Vertebral Artery ◽

Imaging Method ◽

Branching Pattern ◽

Brachiocephalic Trunk

Objectives. The aim was to determine the prevalence of aortic arch variations in 881 patients who underwent neck CT angiography for various reasons. Material and Methods. 881 patients were included in the study who had undergone neck CT angiography between 2010 and 2013. Results. Of 881 patients, 770 (87.4%) patients with classic branching pattern of the aortic arch (AA) were observed. Variations in branching pattern were seen in 111 (12.6%) patients. The most common variation was the origination of the left common carotid artery (LCCA) from the brachiocephalic trunk (BCT). This pattern was observed in 64 (7.2%) cases. In 25 (2.8%) cases, the left vertebral artery (LVA) originated directly from the AA between the origin of the LCCA and left subclavian artery (SCA). 17 (1.9%) cases had aberrant right subclavian artery. Three (0.3%) cases showed right aortic arch. Two cases had right aortic arch with aberrant left subclavian artery. Conclusions. Variations in the branching pattern of the AA are not rare. Head and neck surgeons and interventional radiologists should be aware of aortic arch variations. CTA is a reliable imaging method for demonstrating anatomical features and variations of the AA.

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