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Interventional Cardiology Clinics Apr 2020Carotid atherosclerosis most frequently manifests in the proximal internal carotid artery and the common carotid artery bifurcations. Subclavian artery atherosclerosis... (Review)
Review
Carotid atherosclerosis most frequently manifests in the proximal internal carotid artery and the common carotid artery bifurcations. Subclavian artery atherosclerosis affects the proximal segments with a relatively higher incidence on the left and becomes clinically important in the presence of vertebrobasilar insufficiency or coronary steal. Atherosclerosis of the vertebral artery can lead to posterior circulation stroke. The authors review the major trials on carotid carotid, brachiocephalic and vertebral artery stenosis along with the various available diagnostic and interventional techniques.
Topics: Angiography, Digital Subtraction; Brachiocephalic Trunk; Carotid Arteries; Carotid Artery Diseases; Computed Tomography Angiography; Humans; Magnetic Resonance Angiography; Vascular Surgical Procedures; Vertebral Artery
PubMed: 32147116
DOI: 10.1016/j.iccl.2019.12.008 -
BMC Medical Imaging Aug 2021Brachiocephalic trunk (BCT) variants may have a clinical impact during surgical procedures, some of which could be fatal. The objective of this study was to classify... (Observational Study)
Observational Study
BACKGROUND
Brachiocephalic trunk (BCT) variants may have a clinical impact during surgical procedures, some of which could be fatal. The objective of this study was to classify height positions of the BCT and report their prevalence in a Mexican population.
METHODS
Patients: A retrospective, descriptive, observational, and cross-sectional was performed using computed tomography angiography (CTA) of adult (> 18 years of age) patients, without gender distinction, of Mexican origin. Measuring techniques were standardized using the suprasternal notch to analyze linear and maximum heights, linear and curved lengths, and the vertebral origin and bifurcation levels of the BCT.
RESULTS
A total of 270 CTA were obtained (66.7% men and 33.3% women). A high position of BCT was present in 64.81% (n 175/270). The mean linear medial height was 0.58 ± 1.91 cm, the maximum height of the free edge was 3.85 ± 2.04 cm, side length of the midline at the maximum height of the free edge was 1.46 ± 2.59, linear length 3.72 ± 0.70, and a curve length 3.99 ± 0.79. The BCT origin was most predominant at the T3 (57.9%) and T4 (27.0%) vertebral levels, with the bifurcation at T2 (57.9%) and T1 (36.2%).
CONCLUSIONS
There is a high prevalence of high position BCT in our population. Patients should be assessed before any procedures in the area, due to the potential risk of complications.
Topics: Adult; Brachiocephalic Trunk; Computed Tomography Angiography; Cross-Sectional Studies; Female; Humans; Male; Mexico; Middle Aged; Neck; Retrospective Studies
PubMed: 34388973
DOI: 10.1186/s12880-021-00645-w -
Acta Medica Academica Apr 2023The current report describes two rare cadaveric findings of a left sided brachiocephalic trunk (BCT) in relation to the trachea, and its high-riding course above the...
OBJECTIVE
The current report describes two rare cadaveric findings of a left sided brachiocephalic trunk (BCT) in relation to the trachea, and its high-riding course above the suprasternal notch (SN).
CASES DESCRIPTION
In two elderly body donors dissected after death, a left-sided BCT was identified with a high-riding course (0.5 and 0.8 cm above the SN). The BCT originated from the aortic arch, in common with the left common carotid artery, more distally than the typical left-side location and crossed in front of the trachea. In the 1st case, the ascending and descending aortae, and the left subclavian artery had aneurysmal dilatation. In both cases, the trachea was displaced to the right side and had a stenosis due to the chronic compression.
CONCLUSION
A high-riding BCT is of paramount clinical importance, as it may complicate tracheotomy, thyroid surgery and mediastinoscopy, leading to fatal complications. BCT injury leads to a massive bleeding during neck dissection (level VI), when the vessel crosses the anterior tracheal wall.
Topics: Humans; Aged; Brachiocephalic Trunk; Aorta, Thoracic; Subclavian Artery; Carotid Artery, Common; Cadaver
PubMed: 37326398
DOI: 10.5644/ama2006-124.402 -
Nan Fang Yi Ke Da Xue Xue Bao = Journal... Jun 2023To observe the anatomical features and relative position of the brachiocephalic trunk and the trachea to provide an anatomical basis for diagnosis and treatment of...
OBJECTIVE
To observe the anatomical features and relative position of the brachiocephalic trunk and the trachea to provide an anatomical basis for diagnosis and treatment of mechanical airway obstruction and for facilitating the performance of tracheotomy.
METHODS
A total of 91 formalin- fixed adult cadavers (70 male and 21 female) were used in this study. The whole length of the larynx and the trachea were separated and exposed from the neck to the chest, followed by separation of the aortic arch and its 3 branches to observe the anatomical position of the brachiocephalic trunk and the trachea.
RESULTS
The brachiocephalic trunk and the trachea did not intersect in 3.30%, partially intersected in 71.43%, and completely intersected in 25.27% of the 91 cadaveric specimens. The male specimens all showed greater outer diameter of the aortic arch, the brachiocephalic trunk and the trachea with a greater length of the trachea than the female specimens ( < 0.05), while the distances from the aortic arch to the brachiocephalic trunk or the cricoid cartilage did not differ significantly between them ( > 0.05). The number of the tracheal cartilage rings above the brachiocephalic trunk ranged from 3 to 10, and the mean number did not differ significantly between the male and female specimens ( > 0.05).
CONCLUSION
The brachiocephalic trunk has complex anatomical relationship with the trachea, and caution should be taken to avoid injuries of the brachiocephalic trunk and the aortic arch in the diagnosis and treatment of mechanical respiratory obstruction and during tracheotomy.
Topics: Adult; Female; Male; Humans; Trachea; Brachiocephalic Trunk; Larynx; Cadaver; Formaldehyde
PubMed: 37439169
DOI: 10.12122/j.issn.1673-4254.2023.06.12 -
The Journal of Thoracic and... Dec 2014
Topics: Aorta, Thoracic; Blood Vessel Prosthesis Implantation; Brachiocephalic Trunk; Catheterization; Cerebrovascular Circulation; Circulatory Arrest, Deep Hypothermia Induced; Female; Humans; Male; Perfusion
PubMed: 25172319
DOI: 10.1016/j.jtcvs.2014.07.028 -
Pediatric Cardiology Dec 2018The purpose of the study was to explore the prognosis, as well as antenatal ultrasonic features of isolated left subclavian artery (ILSCA) and isolated left... (Review)
Review
The purpose of the study was to explore the prognosis, as well as antenatal ultrasonic features of isolated left subclavian artery (ILSCA) and isolated left brachiocephalic trunk (ILBCT) malformations, in order to improve prognosis and provide guidance for prenatal diagnosis. The origin and routing of cephalic and cervical vessels were observed in patients diagnosed with right aortic arch or right arterial duct arch in our hospital from March 2015 to March 2017, and the spectrum features related to ILSCA and ILBCT were analyzed. Fetuses diagnosed as ILSCA, or, and ILBCT were followed up for 3 months after birth. At the same time, a literature review was carried out for ILBCT and ILSCA in Pubmed. In our study, two cases with ILSCA and ILBCT were both diagnosed prenatally. They are not accompanied by other congenital malformations or chromosome abnormalities. No abnormality was found during postnatal follow-up except that left radial pulsation was weakened and blood pressure of the left upper limb decreased in baby with ILSCA. In baby with ILBCT, in addition to these abnormal changes, the left common carotid artery pulse disappearance too. In pubmed, three of 12 ILSCA or ILBCT did not have other congenital malformation or chromosome abnormalities. They were not diagnosed until the age of 3, 10, and 47 because of school exams or atypical symptoms, such as headaches, chest pain. Symptom of ILBCT or ILSCA without other abnormality is silent, and therefore they cannot be diagnosed timely after birth prenatal diagnosis is necessary for they can be treated in time.
Topics: Aorta, Thoracic; Aortic Arch Syndromes; Brachiocephalic Trunk; Female; Humans; Male; Pregnancy; Prognosis; Subclavian Artery; Ultrasonography, Prenatal
PubMed: 30167747
DOI: 10.1007/s00246-018-1945-1 -
The Journal of Thoracic and... Feb 2016
Topics: Aorta, Thoracic; Brachiocephalic Trunk; Decompression, Surgical; Diverticulum; Humans; Male; Replantation; Tracheal Stenosis; Vascular Malformations; Vascular Surgical Procedures
PubMed: 26614416
DOI: 10.1016/j.jtcvs.2015.10.084 -
Surgical and Radiologic Anatomy : SRA May 2022To estimate the prevalence of the left-sided aortic arch (LSAA) variants, and the effect of possible moderators on variants' detection. (Meta-Analysis)
Meta-Analysis Review
PURPOSE
To estimate the prevalence of the left-sided aortic arch (LSAA) variants, and the effect of possible moderators on variants' detection.
METHODS
A systematic online literature search was conducted. The pooled prevalence with 95% confidence intervals was estimated for the typical and atypical branching patterns to compare the overall proportions of different variants. Meta-regression analyses were performed to investigate the effect of the subjects' gender and geographical region, and the multidetector computed tomography (MDCT) scanner's technology on the estimated prevalence.
RESULTS
In total, 18,075 cases from 23 imaging studies were included and 33 different LSAA variants were detected. The estimated heterogeneity was statistically significant. Based on the estimated prevalence, approximately 77% of the population is expected to have the typical branching anatomy with sequence brachiocephalic trunk-left common carotid artery-left subclavian artery, and 23% variant branching patterns. Approximately 71%, 23%, 2%, and 0.1% of the atypical populations are expected to have two, four, three, and five emerging branches, respectively. The meta-regression analyses showed that the number of detector rows of the MDCT scanner, and the subjects' geographical region are statistically significant moderators of the estimated prevalence.
CONCLUSION
The current findings indicate that the prevalence of the LSAA variant branching anatomy is significantly affected by the subjects' geographical region and the MDCT scanner's technological improvement, with the advanced scanners to facilitate the detection of the aortic arch variants. However, due to the heterogeneity among studies, further research is required.
Topics: Aorta, Thoracic; Brachiocephalic Trunk; Carotid Artery, Common; Humans; Prevalence; Subclavian Artery
PubMed: 35486163
DOI: 10.1007/s00276-022-02945-4 -
Progress in Cardiovascular Diseases 2021Brachiocephalic and subclavian artery stenoses are less common manifestations of peripheral arterial disease (PAD) compared to lower extremity PAD. However, even among... (Review)
Review
Brachiocephalic and subclavian artery stenoses are less common manifestations of peripheral arterial disease (PAD) compared to lower extremity PAD. However, even among asymptomatic patients, a diagnosis of PAD portends worse long-term mortality. Symptoms may include subclavian steal syndrome and arm claudication. Among patients with internal mammary coronary bypass grafts, symptoms may include those of myocardial ischemia. Symptomatic subclavian stenosis can be readily treated using endovascular techniques with durable outcomes.
Topics: Blood Vessel Prosthesis; Blood Vessel Prosthesis Implantation; Brachiocephalic Trunk; Cardiovascular Agents; Endovascular Procedures; Humans; Intermittent Claudication; Peripheral Arterial Disease; Risk Factors; Stents; Subclavian Artery; Subclavian Steal Syndrome; Treatment Outcome; Vascular Patency; Veins
PubMed: 33744380
DOI: 10.1016/j.pcad.2021.03.004 -
Surgical and Radiologic Anatomy : SRA Nov 2022A female cadaver fixated with 10% formalin solution was dissected during a routine undergraduate anatomy class. It was found that both the right and left carotid...
A female cadaver fixated with 10% formalin solution was dissected during a routine undergraduate anatomy class. It was found that both the right and left carotid arteries arose from a bi-carotid trunk as the first branch of the aortic arch. The bi-carotid trunk was followed by the left subclavian artery. The aberrant right subclavian artery (the last branch) had a retro-oesophageal course. These variations were associated with the linguofacial trunk bilaterally. The group of variant anatomy of vessels encompassing the bi-carotid trunk, aberrant right subclavian artery, and the linguofacial trunk is extremely rare. A similar case has not been reported yet in the literature. The anatomic and morphologic variations of the aortic arch and its branches are important for diagnostic and surgical procedures in the thorax and neck region. Thoracovascular surgeons and interventional radiologists should be aware of these anomalies during head and neck surgery, aortic instrumentation, and four-vessel angiography.
Topics: Female; Humans; Subclavian Artery; Cardiovascular Abnormalities; Brachiocephalic Trunk; Aorta, Thoracic; Carotid Arteries
PubMed: 36273342
DOI: 10.1007/s00276-022-03036-0