Abstract
Objective: The aortic arch develops from multiple components during embryonic development, i.e. aortic sac, branchial arch artery and dorsal aorta. The pattern of fusion of these components results in anatomical variations in adults. The variations of the anatomy of the aortic arch may lead to problems during open vascular and endovascular interventions. The purpose of the study was to identify anatomical variations in the Sri Lankan patients who underwent contrast-enhanced computerised tomography (CECT) of the chest.
Methods: The patients who underwent CECT chest scans for various medical problems in the radiology department in National Hospital, Sri Lanka, Colombo (NHSL) were analysed retrospectively in relation to the variations of the aortic arch and its branches.
Results: A total of 50 (Male: Female = 30:20) were analysed. 20 (40%) had variations in branching patterns. The commonest variation was bovine arch (BA) (common origin of both common carotid arteries from the brachiocephalic trunk or common origin of brachiocephalic trunk and the left common carotid artery from the aortic arch) 28% (n=14). But the association between BA and gender is not statistically significant (p= 0.69). Four (8%) had a left vertebral artery arising from the arch. One (2%) had a right-sided aortic arch and one (2%) had an aberrant right subclavian artery. One (2%) had both BA and left vertebral artery arising from the arch. The difference between variations and gender was also not statistically significant (p= 0.81)
Conclusion: The variations of the aortic arch are common (40%). Knowledge about these variations is essential, especially during thoracic interventions and surgeries. Therefore, prior to any vascular surgical interventions, proper imaging is recommended to delineate the anatomy to prevent unwanted complications.