Prevalence of Bovine Aortic Arch Variant in Patients with Aortic Dissection and its Implications in the Outcome of Patients with Acute Type B Aortic Dissection

Mylonas, Spyridon N.; Barkans, Arthurs; Ante, Marius; Wippermann, Jens; Böckler, D.; Brunkwall, Jan

doi:10.1016/j.ejvs.2017.12.005

Cited by 21 publications

(16 citation statements)

References 31 publications

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“…Although seven types of AA have been described previously, only four types were found in the study population [7]; Type 4, 5 and 7 arches were not reported in the study group. The current study agrees with many previous studies by reporting Type 2 AA as the most prevalent arch variant [4,7,8,12,14,15,[19][20][21]. However, Qiu et al (n = 120) in a cadaveric study have reported type 3 AA (left vertebral artery directly arising from the AA; 7.5%) as the most prevalent anomaly [11].…”

Section: Discussionsupporting

confidence: 91%

“…As described earlier, type 2 AA was the most prevalent variant for many populations [7,[14][15][16][19][20][21].…”

Section: Discussionmentioning

confidence: 97%

“…The aortic arch (AA) branches vascularize the vital structures in the head, neck and upper limbs, including the brain [1,7]. The anatomy of AA has become a well-accepted research topic due to many reasons, such as the signi cant clinical implications of the perfusion territory and the geographical variation in branching pattern [7,14,18,19]. As a pioneer study, this study has evaluated the branching pattern of AA in a selected Sri Lankan population (using contrast-enhanced CT scans of the thorax) and compared the AA anatomy with available data from other communities.…”

Section: Discussionmentioning

confidence: 99%

“…Importantly, type 2 AA has shown a positive association with aortic dilatation and dissection. Also, in aortic dissection, the prognosis of patients with type 2 AA was poor [7,14]. Increased ow velocity in AA due to fewer branches, as seen in the type 2 arch, is the postulated pathophysiology for increased morbidity and mortality in aortic dissection [7].…”

Section: Discussionmentioning

confidence: 99%

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Computed Tomographic Analysis of Aortic Arch Branching Patterns: Revisited

Kodikara

Gamage²,

Soyza

et al. 2022

SN Compr. Clin. Med.

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Background /ObjectivesBranching pattern of aortic arch (AA) has a direct impact on the outcome of thoracic surgical and angiographic procedures. Geographical variations in the branching pattern of AA has been described.Hence, this descriptive cross sectional study describes the AA variations in a Sri Lankan population compared to the available global statistics. MethodsContrast-enhanced computed tomographic studies (CTC) of thorax (n=219) performed in males (49.3%) and females (50.7%); aged 59±17 years (range: 4 to 96 years), were evaluated. Branching patterns of AA were categorized into seven types as described by Popieluszko et al. ResultsFour AA types were identi ed in the study population: Type 1 (90%; n=197), Type 2 (n=10, 4.6%), Type 3 (n=8, 3.7%) and Type 6 AA (n=4; 1.8%). The prevalence of AA variations was 10%.Type 1 was the most prevalent pattern in both genders: female-91%; males-88.9%. The most prevalent AA variant in females was Type 2 (n=6; 5.4%); males Type 3 (n=5; 4.6%). However, the branching pattern of AA has not demonstrated a signi cant gender in uence (Odds: 0.792; 95% CI: 0.327 -1.917; p=0.605). ConclusionVariations in branching pattern of AA is as high as 10% among Sri Lankans. Thus, an in-depth knowledge on population speci c prevalence of AA variants would in uence the modi cations surgical approaches and the choice of angiographic catheters to be utilized, which in turn, would minimize inadvertent vascular injuries during thoracic surgical and angiographic interventions.

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Section: Discussionsupporting

confidence: 91%

“…As described earlier, type 2 AA was the most prevalent variant for many populations [7,[14][15][16][19][20][21].…”

Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Computed Tomographic Analysis of Aortic Arch Branching Patterns: Revisited

Kodikara

Gamage²,

Soyza

et al. 2022

SN Compr. Clin. Med.

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“…This increase in the likelihood of thoracic aortic disease has been related to alterations in blood flow caused by the CILCA, generating areas of accelerated flow and heightened wall shear stress [9], which are linked to endothelial damage and arterial injury [10]. Furthermore, after dissection, patients with CILCA are more likely to undergo surgical aortic repair and present an increased risk of death [9,11]. As a consequence, an early identification of patients with CILCA may be beneficial as it could allow the implementation of tailored surveillance protocols in order to avert unexpected disease diagnoses and potential adverse events.…”

Section: Introductionmentioning

confidence: 99%

A Combined Deep Learning System for Automatic Detection of “Bovine” Aortic Arch on Computed Tomography Scans

Secchi

Interlenghi²,

Alì

et al. 2022

Applied Sciences

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The “bovine” aortic arch is an anatomic variant consisting in a common origin of the innominate and left carotid artery (CILCA), associated with a greater risk of thoracic aortic diseases (aneurysms and dissections), stroke, and complications after endovascular procedures. CILCA can be detected by visual assessment of computed tomography (CT) chest scans, but it is rarely reported. We developed a deep learning (DL) segmentation-plus-classification system to automatically detect CILCA based on 302 CT studies acquired at 2 centers. One model (3D U-Net) was trained from scratch (supervised by manual segmentation), validated, and tested for the automatic segmentation of the aortic arch and supra-aortic vessels. Three DL architectures (ResNet50, DenseNet-201, and SqueezeNet), pre-trained over millions of common images, were trained, validated, and tested for the automatic classification of CILCA versus non-CILCA, supervised by radiologist’s classification. The 3D U-Net-plus-DenseNet-201 was found to be the best system (Dice index 0.912); its classification performance obtained from internal, independent testing on 126 patients gave a receiver operating characteristic area under the curve of 87.0%, sensitivity 66.7%, specificity 90.5%, positive predictive value 87.5%, negative predictive value 73.1%, positive likelihood ratio 7.0, and negative likelihood ratio 0.4. In conclusion, a combined DL system applied to chest CT scans was developed and proven to be an effective tool to detect individuals with “bovine” aortic arch with a low rate of false-positive findings.

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A systematic classification of the left-sided aortic arch variants based on cadaveric studies' prevalence

et al. 2021

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Prevalence of Bovine Aortic Arch Variant in Patients with Aortic Dissection and its Implications in the Outcome of Patients with Acute Type B Aortic Dissection

Abstract: The BA should be considered as a predictor of the outcome for patients with type B aortic dissection.

Cited by 21 publications

References 31 publications

Computed Tomographic Analysis of Aortic Arch Branching Patterns: Revisited

Computed Tomographic Analysis of Aortic Arch Branching Patterns: Revisited

A Combined Deep Learning System for Automatic Detection of “Bovine” Aortic Arch on Computed Tomography Scans

A systematic classification of the left-sided aortic arch variants based on cadaveric studies' prevalence

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