The effect of demographic features on aortic arch anatomy and its role in the etiology of cerebrovascular disease

Abstract

PurposeThe aim of this study was to retrospectively evaluate the distribution of aortic arches, the relationship with demographic characteristics, and the results of carotid and vertebral artery stenting procedures in patients diagnosed with cerebrovascular disease through the intra-arterial digital subtraction angiography (DSA) technique.MethodsA retrospective examination was performed on 288 patients diagnosed with cerebrovascular disease, who underwent DSA in the Department of Neurology of Gaziantep University Medical Faculty and Kahramanmaraş¸ Sütçü Imam University Medical Faculty. The patients were examined in respect of demographic features and aortic arch anatomic structure characteristics. All demographic characteristics, DSA, carotid, and vertebral artery stent results were recorded.ResultsThe patients comprised 60.1% males and 39.9% females with a mean age of 58.25 years. Type 2 aortic arch was found in 175 (60.7%) patients, Type 2 aortic arch in 99 (34.3%) patients, and Type 3 aortic arch in 14 (4.8%) patients. The right carotid artery stenosis rate was found to be higher in patients with Type 2 aortic arch (P=0.013). When the patients were evaluated according to the presence of a bovine arch, there was no significant difference in terms of age, carotid, and vertebral artery lesions (P>0.05).ConclusionThe aortic arch and its branching properties were not found to have a direct effect on increased risk of cerebrovascular disease or stenting rates. This study can be considered to raise awareness for new studies to demonstrate the effect of aortic arch anatomic differences on cerebrovascular diseases.

Is the Anatomical Type of the Arcus Aorta an Effective Factor for the Success of Endovascular Therapy?

“…A study conducted in our country evaluated 270 patients with cerebral angiography and revealed type 1 arch structure in 195 (72.2%) patients, type 2 in 40 (14.8%) patients, and type 3 in 35 (13%) patients (9). Another study in our country by İnanç et al (8) examined 288 patients with cerebral angiography and revealed 175 (61%) patients with type 1, 99 (34%) with type 2, and 14 (5%) with type 3 arch structure. Unlike these studies, our study had a higher type 2 arch structure than the others due to the slightly low average age of our patients.…”

“…A total of 207 patients underwent endovascular procedures with a mean age of 64.4±13 years. The NIHSS score was calculated as median at 15 (12)(13)(14)(15)(16)(17)(18)(19) (percentile 25-75) and the ASPECT score at first arrival was calculated as median at 9 (8,9,10). The IV r-tPA was administered to 36 (17.4%) patients before endovascular treatment.…”

“…A few studies investigated the relationship between the anatomical difference of the aortic arch and cerebrovascular disease. Patil et al (14) argued that a relationship was found between the aortic anatomy and cerebrovascular disease, whereas İnanç et al (8) revealed that the aortic arch and its branching features did not have a direct effect on the increased risk of cerebrovascular disease.…”

“…These arch types, which are important in performing endovascular procedures, are listed from simple to complex as type 1, type 2, and type 3 (Figure 1). The effect of bovine arch structure on the processes was also evaluated (7,8). P values of univariate analyses were adjusted for multiple testing with the false discovery rate method.…”

Pivotal Role of Major Aortic Arch Branches in Subtending the Mammalian Heart

“…All humans are born with a type 1 (totally horizontal) AA [4][5][6][7]. With age, they develop a type 2 (moderately sloping) or a type 3 (severely sloping) AA [4][5][6][7]. Most patients with type 2 and type 3 AA are older and have LVH [2].…”