Anatomic variations of aortic arch branching pattern (543.11)

Abstract

The aortic arch branching pattern was examined in 39 cadaver specimens. The classic branching pattern of the aortic arch consists of the brachiocephalic trunk, left common carotid, and left subclavian arteries.The left and right vertebral arteries are normally branches of the left and right subclavian arteries, respectively.The present study demonstrates variant occurrence of the left common carotid and the left vertebral arteries. The left common carotid in one cadaver originated from the base of the brachiocephalic artery, crossed to the left side anterior to the trachea and then ascended on the left side of the cervical region. This anomaly can have various effects on the hemodynamics of the cerebral circulation and should be identified before performing any surgical procedures involving the aortic arch. In a separate cadaver, the left vertebral artery originated from the aortic arch, approximately 5mm posterior to the origin of the left subclavian artery. The anomalous left vertebral artery measured 7.34mm in diameter, while the right vertebral artery measured 7.26mm. The origin of the left vertebral artery from the aortic arch is significant as it has been associated with a higher incidence of arterial dissection than a left vertebral artery of subclavian origin. Anomalies in the aortic arch branching pattern are likely due to atypical development of the embryonic aortic arch system. A complete understanding of the normal aortic arch branching pattern, as well as its possible variations is vital to successful surgical and medical management of vascular pathologies.