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Bovine arch

Dr Yuranga Weerakkody ◉ and Dr Donna D'Souza ◉ et al.

Bovine arch is the most common variant of the aortic arch and occurs when the brachiocephalic (innominate) artery shares a common origin with the left common carotid artery.

A bovine arch is apparent in ~15% (range 8-25%) of the population and is more common in individuals of African descent.

A related variant, also known as truncus bicaroticus, is the origin of the left common carotid artery from the brachiocephalic artery but not sharing a true common origin, which occurs in ~9% of the population. Sometimes this can be difficult to distinguish from a common origin because the left common carotid artery arises within 1cm of the origin of the brachiocephalic artery.

Clinical presentation

This common variant is asymptomatic most of the time. In rare cases of head and neck surgery, e.g. tracheostomy, it can be a risk factor for injury and cause complications ⁴. In combination with an aberrant right subclavian artery it can cause a dysphagia lusoria.

History and etymology

The name stems from the similarity of this variant with that of a normal bovine arch. A true bovine arch (as found in cattle) has a common single brachiocephalic trunk which trifurcates into bilateral subclavian arteries and a single bicarotid trunk. This variation is very rare in humans.

Presumably somewhere in the animal kingdom is an animal whose aorta actually branches like the so-called bovine pattern. Proposed names are feline/canine/lapine arch.

The term truncus bicaroticus is also not consistent and can be misleading as the branching pattern not only includes the right and left common carotid artery, but also the right subclavian artery.

References

Anatomy: Thoracic

thoracic skeleton
- thoracic cage
  - ribs
    - typical ribs
    - atypical ribs
    - variant anatomy
      - bifid ribs
      - Srb anomaly
  - costal cartilage
  - sternum
- thoracic spine
- articulations
muscles of the thorax
spaces of the thorax
thoracic viscera
blood supply of the thorax
- arteries
  - thoracic aorta (development)
  - pulmonary trunk
    - left pulmonary artery
      - aberrant left pulmonary artery
    - right pulmonary artery
- veins
  - superior vena cava (cavoatrial junction)
  - inferior vena cava
  - coronary veins
    - cardiac veins which drain into the coronary sinus
      - great cardiac vein
      - middle cardiac vein
      - small cardiac vein
      - posterior vein of the left ventricle
      - vein of Marshall (oblique vein of the left atrium)
    - anterior cardiac veins
    - venae cordis minimae (smallest cardiac veins or thebesian veins)
  - pulmonary veins
    - bronchial veins
lymphatics
innervation of the thorax

Article information

rID: 1007

System: Vascular, Chest

Section: Anatomy

Tag: variant, refs

Synonyms or Alternate Spellings:

Bovine type arch
Bovine type aortic arch
Bovine aortic arch
Truncus bicaroticus

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Cases and figures

Figure 1: so called bovine archFigure 1: so called bovine arch

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Case 1Case 1

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Figure 2: true bovine archFigure 2: true bovine arch

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Case 2Case 2

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Case 3: bovine arch (CT)Case 3: bovine arch (CT)

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Case 4: bovine arch (MRA)Case 4: bovine arch (MRA)

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Case 5: bovine arch (DSA)Case 5: bovine arch (DSA)

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Case 6: bovine arch (CTA) Case 6: bovine arch (CTA)

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Case 7: bovine arch with thyroidea ima artery (CTA)Case 7: bovine arch with thyroidea ima artery (CTA)

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Case 8: bovine arch (CTA)Case 8: bovine arch (CTA)

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Case 9: bovine arch on CTCase 9: bovine arch on CT

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Case 10: bovine archCase 10: bovine arch

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Case 11: so called 'bovine' archCase 11: so called 'bovine' arch

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Case 12:Case 12:

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