scholarly journals Fourth branch of arch of aorta and its clinical implication

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.

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

ISRN Anatomy ◽  
2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
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.

scholarly journals Morphological characteristics of the aortic arch organization

2013 ◽  
Vol 19 (2) ◽  
pp. 67-73 ◽  
Author(s):  
A.M. Manole ◽  
D.M. Iliescu ◽  
R. Baz ◽  
P. Bordei
Keyword(s):  
Vertebral Artery ◽  
Aortic Arch ◽  
Subclavian Artery ◽  
Left Subclavian Artery ◽  
Left Vertebral Artery ◽  
Morphological Aspect ◽  
Arterial Trunk ◽  
Brachiocephalic Trunk ◽  
The Right ◽  
Number Of Branches

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

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

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.

Anatomical organization of aortic arch variation with embryological basis and clinical application

2021 ◽  
Vol 9 (1.3) ◽  
pp. 7901-7904
Author(s):  
Gayathri Pandurangam ◽  
◽  
D. Naga Jyothi ◽  
Asra Anjum ◽  
S. Saritha ◽  
...  
Keyword(s):  
Aortic Arch ◽  
Clinical Application ◽  
Surgical Procedures ◽  
Wide Spectrum ◽  
Branchial Arch ◽  
Left Vertebral Artery ◽  
Branching Pattern ◽  
Brachiocephalic Trunk ◽  
Great Vessels ◽  
Arch System

Introduction: The variation in the aortic arch is well known and it has been demonstrated by number of researchers. Changes involved in the development of aortic arch system such as regression, retention or reappearance result in the variation in branching pattern of aortic arch. Variations of the branches of aortic arch are due to alteration of branchial arch arteries during embryonic period. The most common classical branching pattern of the aortic arch in humans comprises of three great vessels, which includes Brachiocephalic trunk, Left Common Carotid artery and Left Subclavian artery. Aim: The study is to determine the embryological basis correlating with clinical application and surgical procedures. Materials and Methods: A study was conducted in 50 formalin fixed cadaveric hearts, during a period of two years. In the routine dissection for 1st MBBS and also museum specimens we encountered 3variations in the branches of arch of aorta. Results: The variations in aortic arch branching pattern were observed in 4 cadaveric hearts (8%). Conclusion: The wide spectrum of variation in the human aortic arch and its branches offer valuable information to catheterize in endovascular surgery for diagnostic and surgical procedures in the thorax, head and neck regions. KEY WORDS: Aortic Arch (AA), Left Common Carotid (LCCA), Left Subclavian (LSA), Brachiocephalic Trunk (BCT), left vertebral artery(LVA).

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
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.

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

2004 ◽  
Vol 10 (4) ◽  
pp. 309-314 ◽  
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.

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

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.

scholarly journals Bilateral Variation in the Origin and Course of the Vertebral Artery

2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
Author(s):  
Aprajita Sikka ◽  
Anjali Jain
Keyword(s):  
Vertebral Artery ◽  
Aortic Arch ◽  
Clinical Significance ◽  
Surgical Procedures ◽  
Cervical Vertebra ◽  
Left Vertebral Artery ◽  
Incomplete Knowledge ◽  
The Third ◽  
Great Vessels ◽  
The Right

Understanding the great vessels of the aortic arch and their variations is important for both the endovascular interventionist and the diagnostic radiologist. An understanding of the variability of the vertebral artery remains most important in angiography and surgical procedures where an incomplete knowledge of anatomy can lead to serious implications. In the present case, a bilateral variation in the origin and course of vertebral artery was observed. The left vertebral artery took origin from the arch of aorta and entered the foramen transversarium of the fourth cervical vertebra. The right vertebral artery took origin from the right subclavian artery close to its origin and entered the foramen transversarium of the third cervical vertebra. The literature on the variations of the artery is studied and its clinical significance and ontogeny is discussed.

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

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
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.

scholarly journals Study of branching pattern of arch of aorta and its variations

2012 ◽  
Vol 01 (04) ◽  
pp. 176-180
Author(s):  
Sanjeev Kumar ◽  
Imtiazul Haq ◽  
Kathiresan K.
Keyword(s):  
Vertebral Artery ◽  
Aortic Arch ◽  
Undergraduate Students ◽  
Clinical Symptoms ◽  
Neck Region ◽  
Left Vertebral Artery ◽  
Common Trunk ◽  
Branching Pattern ◽  
Medical College ◽  
Brachiocephalic Trunk

Abstract Background and aims: Study of branching pattern of arch of aorta and its variation is very significant. This study helps in avoiding the surgical, accidental injuries of blood vessels during cardiovascular surgeries and radiological procedures. Present study is aimed at finding out the branching pattern of arch of aorta, variations of its incidence, clinical significance and to correlate its embryological basis. Materials and methods: Present study was conducted on 30 formalin fixed cadavers, which were allotted to the undergraduate students of Bangalore Medical College and Research Institute. A comparative analysis was done with previous studies. Results: Usual three-branched aortic arch was found in 23 cadavers (76.66% ); variations were found in seven cadavers (23.33% ); 10% presented left vertebral artery arising directly from the arch of aorta; 6.66% presented common trunk of left vertebral artery and left subclavian artery; 3.33% presented thyroidea ima artery arising from the arch; 3.33% presented common trunk of brachiocephalic trunk and left common carotid artery. Conclusion: Variations observed in present study were in par with the variations observed by previous studies. Although anomalous origins of the aortic arch branches very rarely produces clinical symptoms but their knowledge is necessary for operating surgeons and interventional radiologist to avoid complications in the thorax, head and neck region.

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