Surgical and Radiologic Anatomy

, Volume 39, Issue 3, pp 235–242 | Cite as

Branching patterns of the aortic arch: a computed tomography angiography-based study

  • Ayman G. Mustafa
  • Mohammed Z. Allouh
  • Jamaledin H. Abu Ghaida
  • Ma’moon H. Al-Omari
  • Wafa’ A. Mahmoud
Original Article



This study aimed to investigate the anatomical variations in direct branches of the aortic arch in Jordanians using the contrast Computed Tomography (CT) imaging techniques and to determine their prevalence according to sex.


This analytical, retrospective study included 500 patients (209 females, 291 males), who were referred to the Radio-Diagnostic Department at King Abdullah University Hospital for CT angiography of the aortic arch from 2010 to 2014. Patients were selected using a random sampling method.


Six patterns of arrangement of arteries according to their origin from the aortic arch were identified in Jordanians. The most common pattern was the normal classical one and accounted for 61.2 % of cases. All other patterns were considered variations and accounted for 38.8 % of cases. Variation patterns were classified into six different types. There was no significant correlation (p > 0.05) between sex and the occurrence of different types of variations.


This study provides new information regarding the prevalence of aortic arch branching variations in Jordanians. A wide range of anatomical variations in the branching pattern of the aortic arch was observed. This should be taken into consideration during angiography, aortic instrumentation, and supra-aortic thoracic, head, and neck surgery.


Aortic arch Branching pattern Computed tomography Jordanians 


Compliance with ethical standards


This study was funded by a grant from the Deanship of Research at the Jordan University of Science and Technology.

Conflict of interest

The authors have no conflict of interest to declare.


  1. 1.
    Acar M, Ulusoy M, Zararsiz I, Efe D (2013) Anatomical variations in the branching of human aortic arch. Biomed Res 24(4):531–535Google Scholar
  2. 2.
    Bhatia K, Ghabriel MN, Henneberg M (2005) Anatomical variations in the branchesof the human aortic arch: a recent study of a South Australian population. Folia Morphol 64(3):217–224Google Scholar
  3. 3.
    Bhattarai C, Poudel PP (2010) Study on the variation of branching pattern of arch of aorta in Nepalese. Nepal Med Coll J 12(2):84–86PubMedGoogle Scholar
  4. 4.
    Goray VB, Joshi AR, Garg A, Merchant S, Yadav B, Maheshwari P (2005) Aortic arch variation: a unique case with anomalous origin of both vertebral arteries as additional branches of the aortic arch distal to left subclavian artery. AJNR Am J Neuroradiol 26(1):93–95PubMedGoogle Scholar
  5. 5.
    Indumathi S, Sudha S, Hannah Sugirthabai Rajila R (2010) Aortic arch and variations in its branching pattern. J Clin Diagn Res 3134(4):3134–3143Google Scholar
  6. 6.
    Karacan A, Türkvatan A, Karacan K (2014) Anatomical variations of aortic arch branching: evaluation with computed tomographic angiography. Cardiol Young 24(3):485–493CrossRefPubMedGoogle Scholar
  7. 7.
    Khatri R, Maud A, Rodriguez GJ (2010) Aberrant right subclavian artery and common carotid trunk. J Vasc Interv Neurol 3(1):33–34PubMedPubMedCentralGoogle Scholar
  8. 8.
    Mamatha H, Sushma RK, D’Souza AS, Kumar A (2013) Variant branching pattern of the arch of aorta: a study with embryological and clinical implications. Res Rev J Med Health Sci 2(2):48–53Google Scholar
  9. 9.
    McMinn RMH (1994) Last’s anatomy regional and applied, 9th edn. Churchill Livingstone, LondonGoogle Scholar
  10. 10.
    MligilIche NL, Isaac ND (2009) A three branches aortic arch variant with a bi-carotid trunk and a retro-esophageal right subclavian artery. Int J Anat Var 2:11–14Google Scholar
  11. 11.
    Moore KL, Dalley AF, Agur AMR (2010) Clinically oriented anatomy, 6th edn. Lippincott Williams and Wilkins, PhiladelphiaGoogle Scholar
  12. 12.
    Müller M, Schmitz BL, Pauls S, Schick M, Röhrer S, Kapapa T, Schlötzer W (2011) Variations of the aortic arch—a study on the most common branching patterns. Acta Radiol 52(7):738–742CrossRefPubMedGoogle Scholar
  13. 13.
    Natsis KI, Tsitouridis IA, Didagelos MV, Fillipidis AA, Vlasis KG, Tsikaras PD (2009) Anatomical variations in the branches of the human aortic arch in 633 angiographies: clinical significance and literature review. Surg Radiol Anat 31(5):319–323CrossRefPubMedGoogle Scholar
  14. 14.
    Nayak SR, Pai MM, Prabhu LV, D’Costa S, Shetty P (2006) Anatomical organization of aortic arch variations in the India: embryological basis and review. J Vasc Bras 5(2):95–100CrossRefGoogle Scholar
  15. 15.
    Ogeng’o JA, Olabu BO, Gatonga PM, Munguti JK (2010) Branching pattern of aortic arch in a kenyan population. J Morphol Sci 27(2):51–55Google Scholar
  16. 16.
    Patil ST, Meshram MM, Kamdi NY, Kasote AP, Parchand MP (2012) Study on branching pattern of aortic arch in Indian. Anat Cell Biol 45(3):203–206CrossRefPubMedPubMedCentralGoogle Scholar
  17. 17.
    Piyavisetpat N, Thaksinawisut P, Tumkosit M (2011) Aortic arch branches’ variations detected on chest CT. Asian Biomed (Res Rev News) 5(6):817–823Google Scholar
  18. 18.
    Qi R, Sun L, Zhu J, Liu Y, Zheng J, Li C, Chang Q (2013) Total arch replacement in patients with aortic dissection with an isolated left vertebral artery. Ann Thorac Surg 9:36–40CrossRefGoogle Scholar
  19. 19.
    Rekha P, Senthilkumar S (2013) A study on branching pattern of human aortic arch and its variations in South Indian population. J Morphol Sci 30(1):11–15Google Scholar
  20. 20.
    Shakeri A, Pourisa M, Deldar A, Goldust M (2013) Anatomic variations of aortic arch branches and relationship with diameter of aortic arch by 64-raw CT angiography. Pak J Biol Sci 16(10):496–500CrossRefPubMedGoogle Scholar
  21. 21.
    Shetty P, Nayak BS, D’Souza MR, Thangarajan R, Prabhu GS (2013) Variation in the morphology and branching pattern of the aortic arch: a case report. OA Case Rep 2(10):99Google Scholar
  22. 22.
    Shin Y, Chung Y, Shin W, Im S, Hwang S, Kim BT (2008) A morphometric study on cadaveric aortic arch and its major branches in 25 Korean adults: the perspective of endovascular surgery. J Korean Neurosurg Soc 44(2):78–83CrossRefPubMedPubMedCentralGoogle Scholar
  23. 23.
    Shiva Kumar GL, Pamidi N, Somayaji SN, Nayak S, Vollala VR (2010) Anomalous branching pattern of the aortic arch and its clinical applications. Singap Med J 51(11):182–183Google Scholar
  24. 24.
    Snell RS (2007) Clinical anatomy by systems, 1st edn. Lippincott Williams and Wilkins, PhiladelphiaGoogle Scholar

Copyright information

© Springer-Verlag France 2016

Authors and Affiliations

  • Ayman G. Mustafa
    • 1
  • Mohammed Z. Allouh
    • 1
  • Jamaledin H. Abu Ghaida
    • 1
  • Ma’moon H. Al-Omari
    • 2
  • Wafa’ A. Mahmoud
    • 1
  1. 1.Department of Anatomy, Faculty of MedicineJordan University of Science and TechnologyIrbidJordan
  2. 2.Department of Radiology, Faculty of MedicineJordan University of Science and TechnologyIrbidJordan

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