Clinically-relevant morphometric parameters and anatomical variations of the aortic arch branching pattern
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The ever expanding advances in various domains of cardiac and endovascular interventions has drawn tremendous attention toward the importance of the anatomical variability and morphometric parameters of the aortic arch (AA) and its branches.
The current study delineates the morphometry and anatomical variations of the AA branches by evaluating coronal, axial and sagittal CT multiplanar reformatted three-dimensional angiograms. Correlations between morphometric data as well as the distribution of morphometric data in relation to the anatomical variations were also illustrated.
35% of the examined AA showed abnormal branching patterns, the most common of which was the “bovine arch” (24%), followed by common ostium variant (6%) and aberrant left vertebral artery arising directly from AA (5%). The outer diameter of AA at its origin and its end was 33.83 and 22.06 mm, respectively. The distance between the origin of AA and the origin of brachiocephalic trunk (BCT), left common carotid artery (LCCA) and left subclavian artery (LSA) was 19.59, 23.01 and 26.01 mm, respectively. The outer diameter of BCT, LCCA and LSA was 15.7, 11.42 and 14.02 mm, respectively. The angles between the AA and the BCT, LCCA and LSA were 59.01°, 68.59° and 59.92°, respectively. The mean distance between the BCT and LCCA was 19.59 mm and the distance between the LCCA and the LSA was 23.01 mm. Significant positive and negative correlations between morphometric data as well as the distribution of morphometric parameters in relation to the anatomical variations have been identified.
The illustrated anatomical variations and morphometric data provide cardinal information especially for patients undergoing aortic endovascular intervention, principally for choosing the size, shape and type of the angiographic catheters and devices to be delivered.
KeywordsAortic arch Anatomical variations Morphometry Endovascular therapy Aortic aneurysm Aortic dissection
Basma Emad Aboulhoda: project development, manuscript writing. Raed Khairy Ahmed: data collection. Ahmed Sayed Awad: manuscript writing.
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Compliance with ethical standards
Conflict of interest
The authors declare no conflict of interests.
- 2.Budoff M, Dowe D, Jollis J, Gitter M, Sutherland J, Halamert E, Delago A (2008) Diagnostic performance of 64-multidetector row coronary computed tomographic angiography for evaluation of coronary artery stenosis in individuals without known coronary artery disease: results from the prospective multicenter accuracy trial. J Am Coll Cardiol 52:1724–1732CrossRefGoogle Scholar
- 9.Gan H, Bhasin A, Wu C (2010) Transradial carotid stenting in a patient with bovine arch anatomy. Catheter Cardiovasc Interv 75:540–543Google Scholar
- 10.Goray V, Joshi A, 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. Am J Neuroradiol 26:93–95Google Scholar
- 16.Layton K, Kallmes D, Cloft H, Lindell E, Cox V (2006) Bovine aortic arch variant in humans: clarification of a common misnomer. Am J Neuroradiol 27:1541–1542Google Scholar
- 18.Meher R, Sabherwal A, Singh I, Raj A (2004) Dysphagia due to rare cause. Indian J Surg 66:300–301Google Scholar
- 19.Mohor C (2014) Morphometric study of the aoric arch branches. Acta Medica Transilvanica 19:238–239Google Scholar
- 21.Morris P (2013) Practical Neuroangiography, 3rd edn. Lippincott Williams & Wilkins, PhiladelphiaGoogle Scholar
- 28.Rekha P, Senthilkumar S (2013) A study on branching pattern of human aortic arch and its variations in south indian population. J Morphol Sci 30:11–15Google Scholar
- 31.Shiva Kumar G, Pamidi N, Somayaji S, Nayak S, Vollala V (2010) Anomalous branching pattern of the aortic arch and its clinical applications. Singap Med J 51:l182–1183Google Scholar
- 35.Zhang Y, Kaka A, Katiella H, Wang l, Zhang H, Afzal F, Sun H, Xing Y (2016) Anatomical variations of aortic arch branching pattern among the Chinese. IJAAP 2:43–48Google Scholar