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Anatomical variations of aortic arch branching: evaluation with computed tomographic angiography

Published online by Cambridge University Press:  22 May 2013

Alper Karacan ,
Aysel Türkvatan  and
Keziban Karacan
Alper Karacan
Affiliation:
Department of Radiology, Türkiye Yüksek İhtisas Hospital, Ankara, Turkey
Aysel Türkvatan*
Affiliation:
Department of Radiology, Türkiye Yüksek İhtisas Hospital, Ankara, Turkey
Keziban Karacan
Affiliation:
Department of Anatomy, Cumhuriyet University School of Medicine, Sivas, Turkey
*
Correspondence to: Dr A. Türkvatan, Department of Radiology, Türkiye Yüksek İhtisas Hospital, Kızılay street, No. 4, 06100 Sıhhiye, Ankara, Turkey. Tel: +90 312 306 1671; Fax: +90 312 312 4120; E-mail: aturkvatan@yahoo.com
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Abstract

Purpose: The aim of this study was to investigate the frequency and gender distribution of variations in the aortic arch branching pattern using 64-slice computed tomograhic angiography. Materials and methods: A total of 1000 patients with a normal left-sided aortic arch who underwent computed tomographic angiography for various reasons were analysed retrospectively for the frequency of variation of aortic arch branching; the variations were categorised into seven types. Results: Of the 1000 patients, 79.2% had a normal aortic arch branching pattern – type 1 – and 20.8% had variations. The frequency of type 2 variation – brachiocephalic and left common carotid arteries arising from the aortic arch in a common trunk – was 14.1%, that of type 3 – left vertebral artery originating from the aortic arch – was 4.1%, that of type 4 – coexistence of type 2 and type 3 – was 1.2%, that of type 5 – aberrant right subclavian artery – was 0.6%, that of type 6 – coexistence of aberrant right subclavian artery and bicarotid trunk – was 0.7%, and that for type 7 – thyroidea ima artery arising from the aortic arch – was 0.1%. The incidences of the variations of aortic arch branching were similar among males and females (20% versus 22.1%). The incidence of an aberrant right subclavian artery – type 5 and type 6 – was higher among females compared with males (2.5% versus 0.5), whereas the frequencies of the other variations were either equal or similar in both genders. Conclusion: Recognition of variations of aortic arch branching is important because they may cause symptoms due to tracheoesophageal compression or complications during surgical or endovascular interventional procedures of the aorta and its branches.

Keywords

Aortic archvariationanomalymulti-detector computed tomography
Type
Original Articles
Information
Cardiology in the Young , Volume 24 , Issue 3 , June 2014 , pp. 485 - 493
Copyright
Copyright © Cambridge University Press 2013 

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References

1. Thomson, A. Third Annual Report of Committee of Collective Investigation of Anatomical Society of Great Britain and Ireland for the year 1891–92. J Anat Physiol 1893; 27: 183–194.Google ScholarPubMed
2. Adachi, B. Das arterienssystem der Japaner. Kenkyusha, Kyoto, 1928,, pp. 29–41.Google Scholar
3. Donnelly, LF, Fleck, RJ, Pacharn, P, Ziegler, MA, Fricke, BL, Cotton, RT. Aberrant subclavian arteries: cross-sectional imaging findings in infants and children referred for evaluation of extrinsic airway compression. Am J Roentgenol 2002; 178: 1269–1274.CrossRefGoogle ScholarPubMed
4. Alper, F, Akgun, M, Kantarci, M, et al. Demonstration of vascular abnormalities compressing esophagus by MDCT: special focus on dysphagia lusoria. Eur J Radiol 2006; 59: 82–87.CrossRefGoogle ScholarPubMed
5. Türkvatan, A, Büyükbayraktar, FG, Olçer, T, Cumhur, T. Multidetector computed tomographic angiography of aberrant subclavian arteries. Vasc Med 2009; 4: 5–11.CrossRefGoogle Scholar
6. Lee, EY, Siegel, MJ, Hildebolt, CF, Gutierrez, FR, Bhalla, S, Fallah, JH. MDCT evaluation of thoracic aortic anomalies in pediatric patients and young adults: comparison of axial, multiplanar, and 3D images. Am J Roentgenol 2004; 182: 777–784.CrossRefGoogle Scholar
7. Hellinger, JC, Daubert, M, Lee, EY, Epelman, M. Congenital thoracic vascular anomalies: evaluation with state-of-the-art MR imaging and MDCT. Radiol Clin North Am 2011; 49: 969–996.CrossRefGoogle ScholarPubMed
8. Williams, GD, Aff, HM, Schmeckebier, M, Edmonds, HM, Graul, EG. Variations in the arrangement of the branches arising from the aortic arch in American whites and Negroes. Anat Rec 1932; 54: 247–251.CrossRefGoogle Scholar
9. McDonald, JJ, Anson, BJ. Variations in the origin of arteries derived from the aortic arch, in American whites and Negroes. Am J Phys Anthropol 1940; 27: 91–107.CrossRefGoogle Scholar
10. Liechty, JD, Shields, TW, Anson, BJ. Variations pertaining to the aortic arches and their branches. Q Bull Northwest Univ Med Sch 1957; 31: 136–143.Google Scholar
11. Nizankowski, C, Rajchel, Z, Ziolkowski, M. Abnormal origin of arteries from the aortic arch in man. Folia Morphol (Warsz) 1975; 34: 109–116.Google ScholarPubMed
12. Grande, NR, Costa, SA, Pereira, AS, Aguas, AP. Variations in the anatomical organization of the human aortic arch. A study in a Portuguese population. Bull Assoc Anat (Nancy) 1995; 79: 19–22.Google Scholar
13. Nelson, ML, Sparks, CD. Unusual aortic arch variation: distal origin of common carotid arteries. Clin Anat 2001; 14: 62–65.3.0.CO;2-#>CrossRefGoogle ScholarPubMed
14. Nayak, RS, Pai, MM, Prabhu, LV, D'Costa, S, Shetty, P. Anatomical organization of aortic arch variations in the India: embryological basis and review. J Vasc Bras 2006; 5: 95–100.CrossRefGoogle Scholar
15. 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: 319–323.CrossRefGoogle ScholarPubMed
16. Berko, NS, Jain, VR, Godelman, A, Stein, EG, Ghosh, S, Haramati, LB. Variants and anomalies of thoracic vasculature on computed tomographic angiography in adults. J Comput Assist Tomogr 2009; 33: 523–528.CrossRefGoogle ScholarPubMed
17. Jakanani, GC, Adair, W. Frequency of variations in aortic arch anatomy depicted on multidetector CT. Clin Radiol 2010; 65: 481–487.CrossRefGoogle ScholarPubMed
18. Müller, M, Schmitz, BL, Pauls, S, et al. Variations of the aortic arch – a study on the most common branching patterns. Acta Radiol 2011; 52: 738–742.CrossRefGoogle Scholar
19. Faggioli, GL, Ferri, M, Freyrie, A, et al. Aortic arch anomalies are associated with increased risk of neurological events in carotid stent procedures. Eur J Vasc Endovasc Surg 2007; 33: 436–441.CrossRefGoogle ScholarPubMed
20. Dudich, K, Bhadelia, R, Srinivasan, J. Anomalous vertebral artery origin may be an independent risk factor for arterial dissection. Eur J Neurol 2005; 12: 571–572.CrossRefGoogle ScholarPubMed
21. Daentzer, D, Deinsberger, W, Böker, DK. Vertebral artery complications in anterior approaches to the cervical spine: report of two cases and review of literature. Surg Neurol 2003; 59: 300–309.CrossRefGoogle Scholar
22. Kobayashi, M, Yuta, A, Okamoto, K, Majima, Y. Non-recurrent inferior laryngeal nerve with multiple arterial abnormalities. Acta Otolaryngol 2007; 127: 332–336.CrossRefGoogle ScholarPubMed
23. Wells, TR, Landing, BH, Shankle, WR. Syndromal associations of common origin of the carotid arteries. Pediatr Pathol 1993; 13: 203–212.CrossRefGoogle ScholarPubMed
24. Tohno, S, Tohno, Y, Matsumoto, H, et al. A case of the thyroidea ima artery arising from the aortic arch. Kaibogaku Zasshi 1989; 64: 490–494.Google ScholarPubMed
25. Gupta, M, Sodhi, L. Variations in branching pattern, shape, size and relative distances of arteries arising from arch of aorta. Nepal Med Coll J 2005; 7: 13–17.Google ScholarPubMed
26. Shin, IY, Chung, YG, Shin, WH, Im, SB, Hwang, SC, Kim, BT. A morphometric study on cadaveric aortic arch and its major branches in 25 Korean adults: the perspective of endovascular surgery. J Korean Neurosurg Soc 2008; 44: 78–83.CrossRefGoogle Scholar
27. Piyavisetpat, N, Thaksinawisut, P, Tumkosit, M. Aortic arch branches’ variations detected on chest CT. Asian Biomed 2011; 5: 817–823.Google Scholar
28. Molz, G. Aberrant subclavian arteries: predominance in females. Basic Res Cardiol 1976; 71: 420–427.CrossRefGoogle ScholarPubMed