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Anatomical variations in the branches of the human aortic arch in 633 angiographies: clinical significance and literature review

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Abstract

Background

The variations of vessels arising from the aortic arch are numerous. The purpose of the present study is the description of the aortic arch branches’ variations, in order to offer useful data to anatomists, radiologists, vascular, neck and thorax surgeons. In addition, literature has been reviewed so as to enable a comparison of our results with those of other studies and an analysis of the variations’ clinical implications is possible.

Materials and methods

A total of 633 digital subtraction angiographies of Caucasian Greek patients were examined. No computed tomography or magnetic resonance angiographies were included.

Results

Eight types of the aortic arch were found. The classification from I to VIII was made according to the incidences recorded, with type I being the most and type VIII being the least frequent. Type I, brachiocephalic trunk (BT), left common carotid artery (LCC), left subclavian artery (LS), 527 (83%); type II, BT with LCC and LS, 96 (15%); type III, BT, LCC, left vertebral artery (LV), LS, 5 (0.79%); type IV, right subclavian artery (RS), carotids in common, LS, 1 (0.16%); type V, carotids in common-LS, RS, 1 (0.16%); type VI, carotids and subclavians in common, 1 (0.16%); type VII, RS, right common carotid artery (RCC), LCC, LS, 1 (0.16%); type VIII, BT, thyroidea ima, LCC, LS, 1 (0.16%).

Conclusions

Despite the fact that the variations in question are usually asymptomatic, they may cause dyspnea, dysphagia, intermittent claudication, misinterpretation of radiological examinations and complications during neck and thorax surgery. Furthermore, these variations may be accompanied by other congenital abnormalities.

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Fig. 1

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Abbreviations

BT:

Brachiocephalic trunk

RS:

Right subclavian artery

RCC:

Right common carotid artery

LCC:

Left common carotid artery

LS:

Left subclavian artery

LV:

Left vertebral artery

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Authors and Affiliations

  1. Department of Anatomy, Medical School, Aristotle University of Thessaloniki, P.O. Box 300, 54124, Thessaloniki, Greece

    Konstantinos I. Natsis & Prokopios D. Tsikaras

  2. Radiology Department, The “Papageorgiou” General Hospital, Ring Road, Nea Efkarpia, 56429, Thessaloniki, Greece

    Ioannis A. Tsitouridis & Andis A. Fillipidis

  3. Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece

    Matthaios V. Didagelos & Konstantinos G. Vlasis

  4. 7 Paisiou Monaxou, 54632, Thessaloniki, Greece

    Matthaios V. Didagelos

  5. 180 Mihalakopoulou, 11527, Athens, Greece

    Konstantinos G. Vlasis

  6. 33 Kassandrou, 54632, Thessaloniki, Greece

    Prokopios D. Tsikaras

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  1. Konstantinos I. Natsis
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  2. Ioannis A. Tsitouridis
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  3. Matthaios V. Didagelos
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Correspondence to Konstantinos I. Natsis.

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Natsis, K.I., Tsitouridis, I.A., Didagelos, M.V. et al. Anatomical variations in the branches of the human aortic arch in 633 angiographies: clinical significance and literature review. Surg Radiol Anat 31, 319–323 (2009). https://doi.org/10.1007/s00276-008-0442-2

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  • DOI: https://doi.org/10.1007/s00276-008-0442-2

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