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Variant anatomy of the aortic arch

Last revised by Ashesh Ishwarlal Ranchod ◉ on 2 Jul 2023

Citation, DOI, disclosures and article data

Citation:

D'Souza D, Ranchod A, Yap J, et al. Variant anatomy of the aortic arch. Reference article, Radiopaedia.org (Accessed on 09 Dec 2024) https://doi.org/10.53347/rID-917

DOI:

https://doi.org/10.53347/rID-917

Permalink:

https://radiopaedia.org/articles/917

rID:

917

Article created:

2 May 2008, Donna D'Souza

Disclosures:

At the time the article was created Donna D'Souza had no recorded disclosures.

View Donna D'Souza's current disclosures

Last revised:

2 Jul 2023, Ashesh Ishwarlal Ranchod ◉

Disclosures:

At the time the article was last revised Ashesh Ishwarlal Ranchod had no financial relationships to ineligible companies to disclose.

View Ashesh Ishwarlal Ranchod's current disclosures

Revisions:

45 times, by 25 contributors - see full revision history and disclosures

Systems:

Vascular

Sections:

Anatomy

Tags:

normal variant, artery, chest

Synonyms:

Congenital aortic anomalies
Aortic arch variations
Variations of the aortic arch
Variant of the aortic arch
Aortic arch variant
Aortic arch variants
Aortic arch variation
Variants of the aortic arch
Variants of aortic arch

Variant anatomy of the aortic arch occurs when there is failure of normal aortic development. It results in a number of heterogenous anomalies of the aorta and its branch vessels.

Gross anatomy

Normally, the aorta ascends in the superior mediastinum to the level of the sternal notch before arching posteriorly and descending in the left hemithorax. The arch gives off three branch vessels, the brachiocephalic (also called the innominate), left common carotid and left subclavian arteries.

Aortic development is a complex process that takes place during the third week of gestation. During development, the two dorsal aortae fuse to form the descending aorta, the ventral aortic limbs fuse to form the aortic sac, the left 4^th arch vessel becomes the aortic arch and the right 4^tharch vessel becomes atretic distally.

Variant anatomy

Common arch anomalies

When there is departure from normal development, variant anatomy occurs. Commonly, failure of normal regression of the 4^th arch vessels results in a double aortic arch or right-sided aortic arch.

Other arch anomalies

Branch vessel anomalies

Abnormal formation of the 1^st, 2^nd and 3^rd arch vessels results in abnormal branch vessels:

bovine arch (commonest, occurring in 10-20% of the population) ^4,5
thyroidea ima artery (between 4-10 % of cases)
variant origin of vertebral arteries (2.5-6% of cases) ^4,5
aberrant right subclavian artery (in 0.6% of cases) ⁵
aberrant left subclavian artery (right-sided arch)
variant aortic branch vessels
bronchial arteries (case)
common origin of both common carotid arteries

References

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