Computed Tomographic Analysis of Aortic Arch Branching Patterns: Revisited

Abstract

Branching pattern of aortic arch (AA) has a direct impact on the outcomes of thoracic surgical and angiographic procedures. Since, geographical variations in the branching pattern of AA have been described, this descriptive cross-sectional study describes the AA variations in a Sri Lankan population compared to the available global data. For that, contrast-enhanced computed tomographic studies (CTC) of thorax (n = 219) performed in males (49.3%) and females (50.7%), aged 59 ± 17 years (range: 4 to 96 years), were evaluated. Branching patterns of AA were categorized into seven types as described by Popieluszko et al. Only, four AA types were identified in the study population: type 1 (90%; n = 197), type 2 (n = 10, 4.6%), type 3 (n = 8, 3.7%), and type 6 AA (n = 4; 1.8%). The prevalence of AA variations was 10%. Type 1 AA was the most prevalent pattern in both genders: female, 91%; males, 88.9%. The most prevalent AA variant in females was type 2 (n = 6; 5.4%); males type 3 (n = 5; 4.6%). However, the branching pattern of AA has not demonstrated a significant gender influence (odds: 0.792; 95% CI: 0.327–1.917; p = 0.605). Variations in branching pattern of AA are as high as 10% among Sri Lankans. Thus, an in-depth knowledge on population specific prevalence of AA variants would influence the modifications of surgical approaches and the choice of angiographic catheters to be utilized, which in turn would minimize inadvertent vascular injuries during thoracic surgical and angiographic interventions.