Aortic Arch Variants and Anomalies: Embryology, Imaging Findings, and Clinical Considerations

Bae, Sang Bin; Kang, Eun Hae; Choo, Ki Seok; Lee, Jongmin; Kim, Sang Hyeon; Lim, Kyoung Jae; Kwon, Heejin

doi:10.4250/jcvi.2022.0058

Cited by 12 publications

(6 citation statements)

References 107 publications

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“…According to the degree of tracheoesophageal compression, they may cause respiratory or gastroesophageal symptoms. Backer and Mavroudis proposed a classification of vascular rings into four main categories [ 21 ], although many rare variants can be observed [ 22 ]. The most frequent vascular ring (30–50% of cases) is the double aortic arch, due to the persistence of the right and left fourth arches.…”

Section: Congenital Disease Of the Aortamentioning

confidence: 99%

Thoracic Aorta: Anatomy and Pathology

et al. 2023

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The aorta is the largest elastic artery in the human body and is classically divided into two anatomical segments, the thoracic and the abdominal aorta, separated by the diaphragm. The thoracic aorta includes the aortic root, the ascending aorta, the arch, and the descending aorta. The aorta’s elastic properties depend on its wall structure, composed of three distinct histologic layers: intima, media, and adventitia. The different aortic segments show different embryological and anatomical features, which account for their different physiological properties and impact the occurrence and natural history of congenital and acquired diseases that develop herein. Diseases of the thoracic aorta may present either as a chronic, often asymptomatic disorder or as acute life-threatening conditions, i.e., acute aortic syndromes, and are usually associated with states that increase wall stress and alter the structure of the aortic wall. This review aims to provide an update on the disease of the thoracic aorta, focusing on the morphological substrates and clinicopathological correlations. Information on anatomy and embryology will also be provided.

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Section: Congenital Disease Of the Aortamentioning

confidence: 99%

Thoracic Aorta: Anatomy and Pathology

et al. 2023

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“…Many of these variations are clinically significant in terms of involvement by disease process or as an interface in the management of disease which needs to be carefully dealt with. A pre-existing knowledge of these variations helps in better treatment planning and thus minimizing the risk of complications and treatment failures [2][3][4]. In this imaging case series, clinically important variations in aortic branches such as high riding right brachiocephalic artery (BCA), aberrant right subclavian artery, and common celiacomesenteric trunk are being discussed with imaging illustrations and a review of the literature.…”

Section: Introductionmentioning

confidence: 99%

Important Variations of Aortic Branches: Imaging Case Series

Singh

2024

Cureus

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Various anatomical variations are known to occur in branches of the aorta. Some of these variations are common while others are quite uncommon. However, these variations carry significant implications when the patient is diseased and some intervention or surgical procedure is to be done. Most of these variations are usually incidentally detected. This imaging case series illustrates some clinically important variations of aortic branches including branches of the aortic arch and abdominal aorta, with a review of the literature. All cases illustrated here were detected incidentally.

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“…[4]. Bae et al [5] proposed two distinct models of embryogenesis that can explain this system's forms.…”

Section: Introductionmentioning

confidence: 99%

“…This specific condition occurs when the right AA involutes between the RSA, the RCCA, and the regression of the right ductus arteriosus. In this anomaly, the proximal part of the aberrant RSA originates in the lower part of the right dorsal aorta instead of the usual location, the right fourth arch [5,15]. It passes posterior to the esophagus, which can lead to a swallowing difficulty known as "dysphagia lusoria".…”

Section: Introductionmentioning

confidence: 99%

Medical–Surgical Implications of Branching Variation of Human Aortic Arch Known as Bovine Aortic Arch (BAA)

Rotundu,

Nedelcu,

Tepordei

et al. 2024

JPM

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(1) Background: The aortic arch (AA) branching model is challenging, considering the multiple anatomical variations documented in existing research. The bovine aortic arch (BAA) is the most prevalent anatomical variation among these. This variant of AA branching has long been considered a nonsymptomatic malformation, having been discovered incidentally during imaging investigations for other causes. However, more recent studies have demonstrated that BAA shows a frequent association with coarctation of the aorta (CoA), thoracic aortic disease (TAD), and stroke. At the same time, given the current context of increasing activity in the fields of interventional and surgical procedures in the aorta and its branches, it is very important to know the medical–surgical implications of this anatomical variant. (2) Methods: We conducted a comprehensive review using PubMed and Embase, focusing specifically on randomized trials and cohort analyses that examined the medical–surgical implications of BAA. We assessed information related to studied groups, medical procedures, and study outcomes. Initially, we identified 8454 studies, and after rigorous evaluation, we narrowed down our review to 25 articles. (3) Discussions: The intervention consisted of assessing the risks associated with BAA through different imaging investigation methods such as computer tomographic angiography (CTA), magnetic resonance imaging (MRI), or ultrasonography (US). The following results were evaluated: the prevalence of the BAA, the importance of imaging investigations in establishing the diagnosis and the therapeutic management and monitoring the evolution of patients with the BAA, the association of the BAA with CoA, TAD, and stroke, and the potential risks of interventional treatment in patients with the BAA. (4) Conclusions: The prevalence of the BAA differs both between different ethnic groups and between genders. Advanced imaging methods such as CTA and 4D flow MRI allow detailed descriptions of supra-aortic vascular anatomy and information about blood flow velocities, direction, and turbulence in the AA. US remains an easy and valuable imaging investigation, with the potential to detect and correctly diagnose the BAA and its hemodynamic implications. Anatomical variations in the AA are associated with increased rates of TAD, CoA, and stroke, necessitating early diagnosis and increased supervision of patients with such incidentally observed abnormalities. In addition, there is a need to further develop and refine the surgical techniques used and personalize them to the individual characteristics of patients with the BAA.

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Aortic Arch Variants and Anomalies: Embryology, Imaging Findings, and Clinical Considerations

Cited by 12 publications

References 107 publications

Thoracic Aorta: Anatomy and Pathology

Thoracic Aorta: Anatomy and Pathology

Important Variations of Aortic Branches: Imaging Case Series

Medical–Surgical Implications of Branching Variation of Human Aortic Arch Known as Bovine Aortic Arch (BAA)

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