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ISRN Anatomy  2013 

Anatomical Variations in the Branching Pattern of Human Aortic Arch: A Cadaveric Study from Central India

DOI: 10.5402/2013/828969

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Abstract:

Variations of the branches of aortic arch are due to alteration in the development of certain branchial arch arteries during embryonic period. Knowledge of these variations is important during aortic instrumentation, thoracic, and neck surgeries. In the present study we observed these variations in fifty-two cadavers from Indian populations. In thirty-three (63.5%) cadavers, the aortic arch showed classical branching pattern which includes brachiocephalic trunk, left common carotid artery, and left subclavian artery. In nineteen (36.5%) cadavers it showed variations in the branching pattern, which include the two branches, namely, left subclavian artery and a common trunk in 19.2% cases, four branches, namely, brachiocephalic trunk, left common carotid artery, left vertebral artery, and left subclavian artery in 15.3% cases, and the three branches, namely, common trunk, left vertebral artery, and left subclavian artery in 1.9% cases. 1. Introduction Aortic arch (AA) is located in the superior mediastinum. In 65–80% of the cases the three branches arise from aortic arch, namely, the brachiocephalic trunk (BCT), the left common carotid artery (LCCA), and the left subclavian artery (LSA). The point of origin of BCT trunk lies to the right of midvertebral line and that of LCCA and LSA to the left of midvertebral line. Variations in the branching pattern of the AA range from differences in the distance between origins of different branches to the number of branches [1, 2]. The anatomical variations in the branching pattern of AA are significant for diagnostic and surgical procedures in the thorax and neck. The present study describes the AA branching pattern in cadavers from central India and discusses the findings according to their embryological and clinical implications. 2. Material and Method The study was conducted on fifty-two cadavers at the Department of Anatomy, L.N. Medical College and research centre, Bhopal, India. The thoracic cavity was opened by cutting through the costochondral junctions and removing the sternum and costal cartilages. The lungs were removed, superior vena cava and brachiocephalic veins cleared, and pericardium opened to expose ascending aorta. Fibro fatty tissue and nerves were removed to clarify the branches of aortic arch and variations in branching pattern observed. 3. Results In thirty-three (63.5%) cadavers the AA showed classical branching pattern of BCT, LCCA, and LSA (Figure 1). Nineteen (36.5%) cadavers showed variations in the branching pattern as ten (19.2%) cadavers had two branches, namely, LSA and a common trunk

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