Aortic Branch Vessels Research Articles

Variations in Aortic Arch Branch Vessel Anatomy as Seen by Aortography

Several variations in the anatomy of the aortic arch and its branches have been described in the literature based on cadaveric dissection findings. Many of these variations can also be detected by aortic arch arteriography. This study was undertaken to determine the incidence and pattern of variations in aortic arch branch vessel anatomy as seen by aortography. Seventy-six of 705 (10.8%) arteriograms showed variations from normal. A total of 7 variant patterns was identified. The most common abnormality was common origin of innominate artery and left common carotid artery.

The thoracic aorta studied by MR imaging.

Thirty-three patients with a variety of disorders of the thoracic aorta (aneurysm, dissection, Marfan syndrome, coarctation/pseudocoarctation, L-transposition, and Takayasu disease) were evaluated with magnetic resonance (MR) imaging. MR imaging delineated the presence and extent of thoracic aortic aneurysms and showed the relationship of the aneurysm to arch vessels; it also demonstrated intimal flaps and individual lumina in types A and B aortic dissection. Dilation of the ascending aorta in Marfan syndrome and focal narrowing of the aorta in coarctation were well visualized. The anteroposterior and side-to-side relationships of the aorta and pulmonary artery in L-transposition were demonstrated, as were aortic wall thickening and branch vessel narrowing in Takayasu arteritis. Initial experience suggests that MR imaging may provide a noninvasive method for evaluating thoracic aortic disease. Limitations include inferior spatial resolution, occasional difficulty in imaging the entire region of interest in one section, lack of signal from calcifications, and inability to monitor critically ill patients.

Aortic dissection due to translumbar aortography, with recovery following surgery.

Renal and neurological complications are the commonest serious sequelae of abdominal aortography. It has become increasingly evident that in some cases these occasionally fatal complications have been brought about by aortic mural dissection following the injection of dye, with partial or complete occlusion of aortic branch vessels. That this sequence of events can occur was strongly suspected by Gaylis and Laws,¹who produced medial dissection experimentally in human abdominal aortas. However, McAfee,²in a review of data on over 12,000 aortograms, was able to collect only two cases of dissection following aortography, both of which ended fatally. On the other hand, Wolfman and Boblitt³reported four fatal cases from a series of 302 aortograms. In two of these the dissection directly contributed to the death. Fineberg and his associates⁴described a case of gangrene of the large intestine believed to have resulted from this mechanism. Since