The potentially beneficial role of an aortic arch anatomical variant

The left-sided aortic arch variants: prevalence meta-analysis of imaging studies

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.

Anatomical variations of the aortic arch in a sample of Colombian population

Introducción. El arco aórtico (AA) es el origen de estructuras vasculares que suplen los miembros superiores y el encéfalo. Se han descrito hasta ocho diferentes tipos de distribución con implicaciones clínicas y quirúrgicas.Objetivo. Determinar la frecuencia de las variaciones anatómicas del AA y establecer los diámetros vasculares de sus ramas emergentes en una muestra de población colombiana.Materiales y métodos. Se realizó un estudio descriptivo analítico transversal mediante disección de 35 plastrones cervicotorácicos obtenidos con muestreo a conveniencia.Resultados. La distribución de los AA resultó muy similar a la reportada en Colombia y otros países, siendo más frecuente el AA Tipo I seguido del AA Tipo II o arco bovino. Los diámetros vasculares arrojaron resultados análogos a otros obtenidos en población colombiana, pero medias evidentemente menores a las reportadas en estudios internacionales.Conclusión. Aunque las frecuencias de los tipos de AA de la población colombiana resultan ser similares a las de otros países, los diámetros vasculares en Colombia son menores.