ANATOMICAL VARIATIONS OF THE AORTIC ARCH BRANCHING PATTERN

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Background. Anatomical variations of the aortic arch and its branches are fairly common and can have important implications on prognosis and management of surgical interventions, as well as on radiological diagnostics and interventional radiology. Aim. The aim of this study was to present the anatomical variations in branching pattern of the aortic arch in a large group of patients using CTA and consequently to determine their prevalence in our population. Material and Methods. The study population included 1000 patients with referral diagnoses requiring CTA chest radiography, which visualizes the aortic arch. The course of the aortic arch was clearly observed in all of the 1000 patients. The anatomic features of the aortic arch itself and supra-aortic vessels were analyzed, and anatomical variations were recorded on each CT image. Results and Discussion. The results showed that 89.3% of the cases had the usual branching pattern of the aortic arch. The most common variation was aortic arch with two branches, with left common carotid artery arising from brachiocephalic trunk (7.9%). Separate origin of the left vertebral artery between the left common carotid artery and the left subclavian artery was present in 2.8% of cases. Conclusions. The knowledge of the anatomy of the aortic arch and its branches and the awareness of vascular variations is an imperative in diagnostic procedures and in planning surgical interventions during clinical practice.