Anatomy
doi: 10.25005/2074-0581-2023-25-3-400-413
COMPREHENSIVE ANALYSIS OF THE AORTIC ARCH BRANCHING PATTERNS BASED ON DIAGNOSTIC STUDIES, SURGICAL PROCEDURES, AND AUTOPSY REPORTS

O.V. Murashov

Department of Fundamental Medicine and Common Pathology, Institute of Medicine and Experimental Biology, Pskov State University, Pskov, Russian Federation

Objective: : Analysis of literature sources on variant anatomy of arteries arising from aortic arch and branches.

Methods: Analysis of cases of the variant anatomy of arteries arising from the aortic arch (AA) and their branches, based on autopsy, surgery, and modern diagnostic techniques. To gather information, we utilized a range of online resources such as https://www.library.ru, https://www.scopus. com, https://femb.ru/, https://www.cochranelibrary.com/, http://www.acponline.com, https://www.sciencedirect.com/, https://www.embase.com, and the Yandex search engine. The primary research methods utilized were bibliographic and comparative in nature.

Conclusion: The AA anatomy displays frequent variations in medical practice. To prevent complications and errors, it is imperative to thoroughly evaluate the patient before performing angiography, surgery, or any relevant medical procedures.

Keywords: Aortic arch, branches of the aortic arch, brachiocephalic trunk, variant anatomy, variation.

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References
  1. Shevkunenko VN. Geselevich AM. Tipovaya i vozrastnaya anatomiya [Typical and age-related anatomy]. Leningrad-Moskva: Biomedgiz. Leningradskoe otdelenie; 1935. 232 p
  2. Alekseeva NT, Nasonova NA, Sokolov DA, Kvaratskhelia AG, Belov EV, Verikovskaya AV. Redkiy variant mnozhestvennykh anomaliy krovenosnykh sosudov [A rare variant of multiple anomalies of blood vessels]. Sovremennye problemy nauki i obrazovaniya. 2021;5:129.
  3. Bykov PM, Gayvoronsky IV, Gayvoronskaya MG. Sinenchenko GI. Sravnitelnaya kharakteristika morfometricheskikh parametrov bryushnoy aorty i eyo neparnykh vetvey u muzhchin s razlichnym tipom teloslozhenia [Comparative characteristics of morphometric parameters of the abdominal aorta and its unpaired branches in men with different body types]. Zhurnal anatomii i gistologii. 2019;8(2):15-21
  4. Kolsanov AV, Nazaryan AK, Voronin AS, Gelashvili OA. Izuchenie variantnoy anatomii pochechnykh arteriy s pomoshcyu КТ-angiografii [Study of variant anatomy of renal arteries using CT angiography]. Zhurnal anatomii i gistologii. 2020;9(1):43-8
  5. Ivanova PI, Pashko AA, Smirnova OD. Znachenie ucheniya V.I, Shevkunenko na primerakh anatomicheskikh preparatov muzeya kafedry operativnoy khirurgii [The significance of V.N. Shevkunenko's teaching on the examples of anatomical preparations of the Museum of the Department of Operative Surgery]. Forcipe. 2018;1(1):13-58
  6. Gadzhieva FG. Individual`naya izmenchivost` magistral`nych arteriy verchnich i nizhnich konechnostey cheloveka [Individual variability of the main arteries of the upper and lower extremities of a person]. Zhurnal Grodnenskogo gosudarstvennogo meditsinskogo universiteta. 2019;2:105-8.
  7. Pokrovskiy AV [red.]. Klinicheskaya angiologiya. Rukovodstvo. V 2 tomakh. T 1. [Clinical angiology]. Moscow, RF: Meditsinа; 2004. 808 p.
  8. Gossage JA, Ali T, Chambers J, Burnand KG. Peripheral arterial embolism: Prevalence, outcome, and the role of echocardiography in management. Vasc Endovasc Surg. 2006;40:280-6. https://doi.org/10.1177/1538574406291820
  9. Ognerubov NA, Antipova TS. Aberrantnaya pravaya podklyuchichnaya arteriya (arteria lusoria): opisanie sluchaya [Aberrant right subclavian artery (arteria lusoria): Case description]. Vestnik Tambovskogo universiteta. Seriya estestvennykh i tekhnicheskikh nauk. 2017;22(6-2):1473-7.
  10. Freund GG, Danilova MA, Baydina TV. Kliniko-morfologicheskaya kharakteristika ateroskleroza sonnykh arteriy [Clinical and morphological characteristics of carotid atherosclerosis]. Problemy ekspertizy v meditsine. 2012;3/4:26-9.
  11. Kabak SL, Gaydel IK, Melnichenko UM. Kliniko-morfologicheskie aspecty bessimptomnoy polnoy okkluzii ekstracranial`nogo otdela vnutrenney sonnoy arterii [Clinical and morphological aspects of asymptomatic complete occlusion of the extracranial part of the internal carotid artery]. Zhurnal anatomii i gistologii. 2021;10(2):80-3.
  12. Vereshchagin SV, Ahmad MMD, Kucher VN, Chubko VI, Dzyuba DA. Pervyy opyt endovaskulyarnogo lechenia posttravmaticheskikh anevrizm vetvey dugi aorty [The first experience of endovascular treatment of posttraumatic aneurysms of the branches of the aortic arch]. Endovaskularnaya neyrorentgenokhirurgiya. 2014;2(8):64-70.
  13. Ivanov VA, Dmitraschenko AA, Ivanov AV, Klyanshin AA. Traditsionnaya i komp’yuterno-tomograficheskaya angiografiya v diagnostike sosudistykh povrezhdeniy shei [Traditional and computed tomographic angiography in the diagnosis of vascular neck injuries]. Diagnosticheskaya i interventsionnaya radiologiya. 2019;13(1):50-8.
  14. Kalinin RE, Suchkov IA, Mzhavanadze ND, Mustafaeva RM. Varianty klinicheskoy anatomii arteriy verkhnikh konechnostey [Clinical anatomy of the upper limb arteries]. Vestnik Avitsenny [Avicenna Bulletin]. 2017;19(1):113-9. https:// doi.org/10.25005/2074-0581-2017-19-1-113-119
  15. Pandalai U, Pillay M, Moorthy S, Sukumaran TT, Ramakrishman S, Gopalakrishnan A, et al. Anatomical variations of the aortic arch: A computerized tomography-based study. Cureus. 2021;13(2):e13115. https://doi.org/10.7759/cureus.13115
  16. Yousef S, Singh S, Alkukhun A, Alturkmani B, Mori M, Chen J, et al. Variants of the aortic arch in adult general population and their association with thoracic aortic aneurysm disease. J Card Surg. 2021;36(7):2348-54. https://doi. org/10.1111/jocs.15563
  17. Zaikina NV, Agafonova LV, Zaikina MP. Obraznye sravneniya i eponymy v funktsianal`noy diagnostike. Chast` 1. Electrokardiografiya [Figurative comparisons and eponyms in functional diagnostics. Part 1. Electrocardiography]. Meditsinskiy alfavit. 2019;4:22-7
  18. Goldsher YW, Salem Y, Weisz B, Achiron R, Jacobson JM, Gindes L. Bovine aortic arch: Prevalence in human fetuses. J Clin Ultrasound. 2020;48:198-203. https://doi.org/10.1002/jcu.22800
  19. Rekha P, Senthilkumar S. A study on branching pattern of human aortic arch and its variations in South Indian population. Journal of Morphology. 2013;30(1):11-5.
  20. Bhatia K, Gabriel MN, Henneberg M. Anatomical variations in the branches of the human aortic arch: A recent study of a south Australian population. Folia Morphol (Warsz). 2005;64(3):217-23.
  21. Indumathi S, Sudha S, Rajila HS. Aortic arch and variations in its branching pattern. Journal of Clin and Diagnostic Research. 2010;4:3134-43.
  22. Junagade B, Mukherjee A. Study of the normal and variant branching pattern of the aortic arch: the clinical and embryological significance. Global Journal for Research Analysis. 2015;4(5):141-3
  23. Junagade B, Mukherjee A. The morphometric study of the normal and variant branching pattern of the aortic arch by cadaveric dissection. International Journal of Medical Research Review. 2015;3(5):461-9.
  24. Faggioli GL, Ferry M, Freyrie A, Garguilo M, Fratesi F, Rossi C. Aortic arch anomalies are associated with increased risk of neurological events in carotid stent procedures. Eur J Vasc Endovasc Surg. 2007;33(4):436-41. https://doi. org/10.1016/j.ejvs.2006.11.026
  25. Einstein EH, Song LH, Villela NLA, Fasani-Felberg GB, Jacobs JL, Kim DO. Anomalous origin of left vertebral artery from the aortic arch. Aorta (Stamford). 2016;4:64-7. https://doi.org/10.12945/j.aorta.2015.15.022
  26. Shevkuta GV, Yakovleva NV, Shnukova TV. Ateroskleroticheskie i neateroskleroticheskie izmeneniya brakhiotsefal`nych areteriy kak prediktory mozgovykh i koronarnykh sobytiy (obzor literatury) [Atherosclerotic and non-atherosclerotic changes in brachiocephalic arteries as predictors of cerebral and coronary events (literature review)]. Yuzhno-Rossiyskiy zhurnal terapevticheskoy praktiki. 2020;1(3):7-15.
  27. Shin Y, Chung Y, Shin WH, Im SB, Hwang SC, Kim BT. A morphometric study on cadaveric aortic arch and its major branches in 25 Korean adults: The perspective of endovascular surgery. J Korean Neurosurg Soc. 2008;44(2):78-83. https://doi.org/10.3340/jkns.2008.44.2.78
  28. Kozlov BN, Panfilov DS, Petrakova EA. Assotsiatsiya variantnoy anatomii dugi aorty s aortal`nymi sostoyaniyami [Association of variant anatomy of the aortic arch with aortic conditions]. Minimal`no invazivnaya serdechno-sosudistaya khirurgiya. 2023;2(1):18-23
  29. Hornick M, Moomiaie R, Mojibian H, Ziganshin B, Almuwaqqat Z, Lee ES, et al. «Bovine» aortic arch – a marker for thoracic aortic disease. Cardiology. 2012;123(2):116-24. https://doi.org/10.1159/000342071
  30. Abugov SA, Polyakov RS, Karamyan DA, Puretskiy MV, Mardanyan GV, Charchyan ER. Modern condition of the problem of endovascular treatment in type B aortic dissection. Russian Journal of Endovascular Surgery. 2021;8(2):121-34.
  31. Karacan A, Türkvatan А, Karacan К. Anatomical variations of aortic arch branching: Evaluation with computed tomographic angiography. Саrdiol Young. 2014;24(3):485-93. https://doi.org/10.1017/S1047951113000656
  32. Natsis K, Piagkou M, Lazaridis N, Kalamatianos T, Chytas D, Manatakis D, Anastasopoulos N, Loukas M. A systematic classification of the left-sided aortic arch variants based on cadaveric studies’ prevalence. Surg Radiol Anat. 2021;43(3):327-45. https://doi.org/10.1007/s00276-020-02625-1
  33. Açar G., Çiçekcibaşı AE, Uysal E, Koplay M. Anatomical variations of the aortic arch branching pattern using CT angiography: A proposal for a different morphological classification with clinical relevance. Anat Sci Int. 2022;97(1):65-78. https://doi.org/10.1007/s12565-021-00627-6
  34. Alsaif HA, Ramadan WS. An anatomical study of the aortic arch variations. JKAU: Med Sci. 2010;17(2):37-54.
  35. Açar M, Ulusoy M, Zararsiz I, Efe D. Anatomical variations in the branching of human aortic arch. Biomedical Research. 2013;24(4):531-5.
  36. Meyer AM, Turek GW. Insight into arch vessel development in the bovine aortic arch. Pediatr Cardiol. 2019;40(7):1445-9. https://doi.org/10.1007/s00246- 019-02156-6
  37. Turek JW, Conway BD, Cavanaugh NB, Meyer AM, Aldos A, Reinking BE, et al. Bovine arch anatomy influences recoarctation rates in the era of the extended end-to-end anastomosis. Int J Thorac Cardiovasc Surg. 2018;155(3):1178-83. https://doi.org/10.1016/j.jtcvs.2017.10.055
  38. Shang M, Vinholo TF, Buntin J, Zafar MA, Ziganshin BA, Elefteriades JA. Bovine aortic arch: A result of chance or mandate of inheritance? Am J Cardiol. 2022;172:115-20. https://doi.org/10.1016/j.amjcard.2022.02.030
  39. Susanin NV, Odintsov NS, Vanyurkin AG, Solovyev VA, Belova YuK, Chernyavskiy MA. Endovascular aortic arch surgery: A single center experience. Russian Journal of Endovascular Surgery. 2022;9:138-44.
  40. Ogengo’o JA, Olabu BO, Gatonga PM, Munguti JK. Branching pattern of aortic arch in a Kenyan population. J Morphol Sci. 2010;27(2):51-5.
  41. Shadanov AA, Sirota DA, Bergen TA, Lyashenko MM, Chernyavskiy AM. Anatomicheskaya variabel’nost stroeniya dugi i grudnogo otdela aorty i eyo vliyanie na patologicheskie sostoyaniya aorty [Anatomical variability of the structure of the arch and thoracic aorta and its effect on the pathological conditions of the aorta]. Patologiya krovoobrashcheniya i kardiokhirurgiya. 2020;24(4):72-82.
  42. Pandian DK, Radha K, Sundaravadhanam KVK. Study on branching pattern of arch of aorta in South Indian population. International Journal of Anatomy and Research. 2014;2(4):673-6
  43. Williams GD, Edmonds HW. Variations in the arrangement of the branches arising from the aortic arch in American whites and negroes. Anat Rec. 1935;62:139-46.
  44. Atay Y, Engin C, Posacioglu H, Ozyurek R, Ozcan C, Yagdi T, et al. Surgical approaches to the aberrant right subclavian artery. Tex Heart Inst J. 2006;33(4):477-81
  45. Murzi M, Mariani M, Tiwari KK, Farneti P, Berti S, Karimov JH, et al. Aberrant right subclavian artery aneurysm in coexistence with a common carotid trunk. Ann Thorac Surg. 2009;88(1):8. https://doi.org/10.1016/j.athoracsur.2009.04.110
  46. Diani A, Benfaddoul O, Zouita B, Basraoui D, Jalal H. Isolated left subclavian artery with right aortic arch: Case report. J Pediatr Res Rev Rep. 2023;5(1):1-3. https://doi.org/10.47363/JPRRR/2023(5)149
  47. Alhuzaimi AN, Aldawsari KA, AlAhmadi M. Isolated left subclavian artery with right aortic arch: Case report and literature review of 50 cases. Gen Thorac Cardiovasc Surg. 2021;68:885-9. https://doi.org/10.1007/s11748-020-01564-3
  48. Rybakov AG, Loshkaryov IA, Machinskiy PA. Plotnikova NA. Variantnaya anatomiya vetvey dugi aorty [Variant anatomy of aortic arch branches]. Operativnaya khirurgiya i klinicheskaya anatomiya. 2018;2(2):35-6.
  49. Graudina VE, Zulfigarova BT, Kostina IV, Ausheva FI, Botez LS. Anatomiya razvitiya vetvey dugi aorty s polnym STEAL-sindromom: klinicheskiy sluchay redkoy diagnosticheskoy nakhodki [Anomaly of development of branches of the aortic arch with complete STEAL syndrome: A clinical case of a rare diagnostic finding]. Mezhdunarodnyy zhurnal serdtsa i sosudistykh zabolevaniy. 2022;10:39- 46.
  50. Kalinichenko VM, Blagonravova IO. Redkiy variant razvitiya i stroeniya dugi aorty i eyo vetvey [A rare variant of the development and structure of the aortic arch and its branches]. Morfologiya. 2009;136(4):69a
  51. Kazakevich AS, Stelmashchuk AA, Bazhenov DV, Blinova NV, Kiselyov DV. Sravnitel`nyy dvustoronniy analiz osnovnykh sosudov golovy i shei trupa zhenskogo pola [Comparative bilateral analysis of the main vessels of the head and neck of a female corpse]. Tverskoy meditsinskiy zhurnal. 2016;3:55-8.
  52. Kumar S, Kumar P. Trunkus bicaroticus with aberrant right subclavian artery and origin of right vertebral from right common carotid artery. Surg Radiol Anat. 2014;36(8):829-31. doi: 10.1007/s00276-013-1232-z
  53. Gluncic V, Ivkic G, Marin D, Percac S. Anomalous origin of both vertebral arteries. Clin Anat. 1999;12:281-4. https://doi.org/10.1002/(SICI)1098- 2353(1999)12:4<281::AID-CA8>3.0.CO;2-6
  54. Cetin I, Varan B, Orün UA, Tokel K. Common trunks of the subclavian and the vertebral arteries: Presentation of a new aortic arch anomaly. Ann Vasc Surg. 2009;23(1):142-3. https://doi.org/10.1016/j.avsg.2008.02.015
  55. Wiedemann D, Kocher A, Mahr S, Longato S, Bonaros N, Schachner T. Extraordinary branching pattern of the aortic arch. Clin Anat. 2013;26(8):1006-7. https://doi.org/10.1002/ca.22208
  56. Rapotra M, Abraham J, Sharma A. Anomalous aortic origin of left vertebral artery – a case report. International Journal of Health Sciences and Research. 2015;5(6):667-72
  57. Rapotra M, Abraham J, Sharma A. Anomalous aortic origin of left vertebral artery – a case report. International Journal of Health Sciences and Research. 2015;5(6):667-72
  58. Chernykh AV, Yakusheva NV, Vitchinkin VG, Zakurdaev EI, Kosyanchuk NM. Sluchay aberrantnoy pravoy podklyuchichnoy arterii (arteria lusoria). Klinicheskiy sluchay [A case of aberrant right subclavian artery (arteria lusoria). Case report]. Zhurnal anatomii i gistopatologii. 2015;4(2):68-70.
  59. Cheng M, Xiaodong X, Wang C, You C, Mao B, He M, et al. Two anatomic variations of the vertebral artery in four patients. Ann Vasc Surg. 2009; 23(5):689. e1-5. https://doi.org/10.1016/j.avsg.2009.06.007
  60. Dvornichenko VV, Masnikova UK, Mirochnik V, Prosekin KS. Redkiy variant anatomii nizhney shchitovidnoy arterii: otkhozhdenie ot obshchey sonnoy arterii [A rare variant of the anatomy of the lower thyroid artery: Origin from the common carotid artery]. Voprosy onkologii. 2018;64(6):815-7.

Authors' information:

Murashov Oleg Vasilievich,
Senior Lecturer, Department of Fundamental Medicine and Common Pathology, Institute of Medicine and Experimental Biology, Pskov State University
ORCID ID: 0000-0003-0821-847Х
E-mail: ps60rus@mail.ru

Information about support in the form of grants, equipment, medications

The author did not receive financial support from manufacturers of medicines and medical equipmen

Conflicts of interest: No conflict

Address for correspondence:

Murashov Oleg Vasilievich
Senior Lecturer, Department of Fundamental Medicine and Common Pathology, Institute of Medicine and Experimental Biology, Pskov State University

Tel.: +7 (921) 2159674

E-mail: ps60rus@mail.ru

Materials on the topic:
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  2. THE USE OF ANATOMIC TABLE FOR STUDYING THE VARIANT ANATOMY OF THE SUBCLAVIAN AND AXILLARY ARTERIES

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