ANATOMICAL VARIATIONS OF THE AORTIC ARCH

  • Julija Zivadinovik Institute of Anatomy, Medical Faculty, Skopje, R. Macedonia
  • Niki Matveeva Institute of Anatomy, Medical Faculty, Skopje, R. Macedonia
  • Biljana Zafirova Institute of Anatomy, Medical Faculty, Skopje, R. Macedonia
  • Ace Dodevski Institute of Anatomy, Medical Faculty, Skopje, R. Macedonia
  • Tanja Petrovska PHI University Clinic for Surgical Diseases "St. Naum Ohridski-Skopje"

Abstract

Anatomical variations of the aortic arch and its branches can have important implications on prognosis and management of surgical interventions, as well as on radiological diagnostics and interventional radiology. The presence and the pattern of arch variants may increase the technical difficulty of surgical procedures, thus detailed evaluation of aortic arch anatomy is important for planning thoracic surgery and endovascular interventions.


The aim of this study was to present the anatomical variations of the aortic arch and its branches in a large group of patients using CTA and consequently to obtain data on their representation in our population.


The study population included 550 patients with referral diagnoses requiring CTA chest radiography, which visualizes the aortic arch.


The anatomic features of the aortic arch itself and supra-aortic vessels were analyzed, and anatomical variations were recorded on each CT image.


The results showed that 91.3% of the patients had the usual pattern of the aortic arch, 8.7% had variations in the number of the supra-aortic vessels. The most common variation of the number of the aortic arch branches was their reduction to two, with left common carotid artery arising from brachiocephalic trunk (5.63%).


The knowledge of the anatomy of the aortic arch and its branches and identification of arch anomalies allow accurate surgical and intervention planning and helps avoiding potential complications.

References

1. Vučurević G, Marinković S, Puškaš L, Kovačević I, Tanasković S, Radak D, Ilić A. Anatomy and radiology of the variations of aortic arch branches in 1,266 patients. Folia Morphol. 2013; 72(2):113–22.
2. Bhatia K, Ghabriel MN, Henneberg M. Anatomical variations in the branches of the human aortic arch: a recent study of a South Australian population. Folia Morphol 2005; 64: 217–224.
3. Cheng M, Xiadong X, Wang C, You C, Mao B, He M, Zhang C. Two anatomic variations of the vertebral artery in four patients. Ann Vasc Surg 2009; 23: 689, e1–5.
4. Natsis K, Didagelos M, Manoli SM, Papathanasiou E, Sofidis G, Anastasopoulos N A bicarotid truk in association with an aberrant right subclavian artery. Report of two cases, clinical impact, and review of the literature. Folia Morphol 2011; 70: 68–73.
5. Sadler TW. Cardiovascular system. In: Sadler TW ed.. Langman’s medical embryology. 10th Ed. Lippincott Williams Wilkinson, a Wolters Kluwer business, Philadelphia, 2006, pp. 159–194.
6. Atkin GK, Grieve PP, Vattipally VR, Ravikumar KH, Das SK. The surgical management of aortic root vessel anomalies presenting in adults. Ann Vasc Surg 2007 21: 525–34.
7. Cinŕ CS, Arena GO, Bruin G, Clase CM. Kommerell’s diverticulum and aneurysmal right-sided aortic arch: A case report and review of literature. J Vasc Surg 2000; 32:1208–14.
8. Fazan VPS, Ribeiro RA, Ribeiro JAS, Filho OAR. Right retroesophageal subclavian artery. Acta Cirurg Bras 2003; 18 (suppl. 5): 54–6.
9. Kumar S, Pamidi N, Somayaji SN, Nayak S, Vollala VR. Anomalous branching pattern of the aortic arch and its clinical applications. Singapore Med J 2010; 51:e182–e183.
10. Natsis KI, Tsitouridis IA, Didagelos MV, Fillipidis AA, Vlasis KG, Tsikaras PD. Anatomical variations in the branches of the human aortic arch in 633 angiographies: clinical significance and literature review. Surg Radiol Anat 2009; 31: 319–23.
11. Nakhla OL. Role of multi- slice CT angiography in the evaluation of conotruncal anomalies. The Egyptian Journal of Radiology and Nuclear Medicine 2015; 46: 371–7.
12. Hanneman K, Newman B, Chan F. Congenital variants and anomalies of the aortic arch. RG 2017; 37(1):32-51.
13. Kau T, Sinzig M, Gasser J et al. Aortic development and anomalies. Semin Intervent Radiol 2007;24(2):141–52.
14. Williams PL, Bannister LH, Berry MN, Collins P, Dyson M, Dussek JE, Ferguson MWJ. Gray`s anatomy. 38th ed. New York: Churchill Livingstone; 2006.
15. Moore KL, Dali AF, Agur AMP. Clinically Oriented Anatomy. 9th Edition. Skopje: Tabernakul; 2011.
16. Zhivadinovik J. Morphology and developmental anatomy of aortic arch. Acta morphol. 2010; 7 (2): 16-22.
17. Zhivadinovik J. Morfologija na aortniot lak kaj novorodeni i mrtvorodeni. Magisterski trud. UKIM, Skopje, 2000.
Published
2018-04-03
How to Cite
ZIVADINOVIK, Julija et al. ANATOMICAL VARIATIONS OF THE AORTIC ARCH. Journal of Morphological Sciences, [S.l.], v. 1, n. 1, p. 20-24, apr. 2018. ISSN 2545-4706. Available at: <https://jms.mk/jms/article/view/11>. Date accessed: 03 dec. 2022.
Section
Articles