A rare case of double variation of the aortic arch («bovine arch» and aberrant left vertebral artery)
https://doi.org/10.34680/2076-8052.2025.2(140).191-202
Abstract
The aim of this study was to examine the variant anatomy of the brachiocephalic arteries and their branches with the registration of the most known morphometric parameters. The study material was impersonal computerized tomography angiograms of a rare case of variant anatomy of the brachiocephalic arteries of a 58-year-old female. During our work we identified such a phenomenon as «bovine arch» and aberrant left vertebral artery branching off from the aortic arch. The discovery of such a finding during surgery without a thorough preliminary examination of the patient can create certain technical difficulties for the surgeon.
About the Authors
O. V. MurashovRussian Federation
Pskov
N. V. Ivanova
Russian Federation
Pskov
T. M. Komandresova
Russian Federation
Pskov
M. S. Begun
Russian Federation
Pskov
A. G. Nasedkin
Russian Federation
Pskov
O. S. Ishchenko
Russian Federation
Pskov
M. D. Luppo
Russian Federation
Pskov
References
1. Shkurin V. F., Murashov O. V. Temporary bleeding control. Pskov: OTSNT Publ., 2002. 60 p. (In Russian).
2. Ivanov V. A., Dmitraschenko A. A., Ivanov A. V., Klyanshin A. A. Traditional and computed tomographic angiography in the diagnosis of vascular neck injuries // Diagnostic and interventional radiology. 2019. 13 (1). 50-8. DOI: 10.25512/DIR.2019.13.1.06 (In Russian).
3. Pokrovskiy A. V. (ed.). Clinical Angiology: a guide for doctors: in 2 vols. Vol. 1. Moscow: Medicine Publ., 2004. 808 p. (In Russian).
4. Gossage J. A., Ali T., Chambers J., Burnand K. G. Peripheral arterial embolism: prevalence, outcome, and the role of echocardiography in management // Vascular and endovascular surgery. 2006. 40 (4). 280–286. DOI: 10.1177/1538574406291820
5. Ognerubov N. A., Antipova T. S. Aberrant right subclavian artery (arteria lusoria): case description // Vestnik of Tambov university. Series Natural and technical sciences. 2017. 22 (6-2). 1473–1477. DOI: 10.20310/1810-0198-2017-22-6-1473-1477 (In Russian).
6. Vanurkin A. G., Soboleva A. V., Susanin N. V., Belova U. K., Solov`yov V. A., Chernyavskiy М. А. Endovascular treatment of multilevel lesions of the brachiocephalic arteries in asymptomatic patients: a series of clinical cases // Pathology of blood circulation and cardiac surgery. 2022. 26 (4). 52–59. DOI: 10.21688/1681-3472-2022-4-52-59 (In Russian).
7. DeCarlo C., Tanious A., Boitano L. T., Mohebali J., Stone D. H., Clouse W. D., Conrad M. F. Simultaneous treatment of common carotid lesions increases the risk of stroke and death after carotid artery stenting // Journal of vascular surgery. 2021. 74 (2). 592–598. DOI: 10.1016/j.jvs.2020.12.089
8. Williams G. D., Edmonds H. W. Variations in the arrangement of the branches arising from the aortic arch in American whites and negroes // Anatomical record. 1935. 62. 139–146. DOI: 10.1002/ar.1090620203
9. Einstein E. H., Song L. H., Villela N. L. A., Fasani–Felberg G. B., Jacobs J. L., Kim D. O. Anomalous origin of the left vertebral artery from the aortic arch // Aorta (Stamford). 2016. 4 (2). 64–67. DOI: 10.12945/j.aorta.2015.15.022
10. Indumathi S., Sudha S., Rajila H. S. Aortic arch and variations in its branching pattern // Journal of clinical and diagnostic research. 2010. 4 (5). 3134–3143.
11. Shadanov A. A., Sirota D. A., Bergen T. A., Lyashenko M. M., Chernyavsky A. M. Anatomical variability of the structure of the arch and thoracic aorta and its effect on the pathological conditions of the aorta // Pathology of blood circulation and cardiac surgery. 2020. 24 (4). 72–82. DOI: 10.21688/1681-3472-2020-4-72-82 (In Russian).
12. Kozlov B. N., Panfilov D. S., Petrakova E. A. Association of variant anatomy of the aortic arch with aortic conditions // Minimally invasive cardiovascular surgery. 2023. 2 (1). 18–23. (In Russian).
13. Hornick M., Moomiaie R., Mojibian H., Ziganshin B., Almuwaqqat Z., Lee E. S., Rizzo J. A., Tranquilli M., Elefteriades J. A. «Bovine» aortic arch – a marker for thoracic aortic disease // Cardiology. 2012. 123 (2). 116–124. DOI: 10.1159/000342071
14. Meyer A. M., Turek G. W., Froud J., Edelman L. A., Cavanaugh N. B., Torre J., Ravi Ashwath R. Insight into arch vessel development in the bovine aortic arch // Pediatric cardiology. 2019. 40 (7). 1445–1449. DOI: 10.1007/s00246-019-02156-6
15. Turek J. W., Conway B. D., Cavanaugh N. B., Meyer A. M., Aldos A., Reinking B. E., El-Hattab A., Rossi N. P. Bovine arch anatomy influences recoarctation rates in the era of the extended end-to-end anastomosis // Journal of thoracic and cardiovascular surgery. 2018. 155 (3). 1178–1183. DOI: 10.1016/j.jtcvs.2017.10.055
16. Kalinichenko V. M., Blagonravova I. O. A rare variant of the development and structure of the aortic arch and its branches // Morphology. 2009. 136 (4). 69a. (In Russian).
17. Alsaif H. A., Ramadan W. S. An anatomical study of the aortic arch variations // Journal of king Abdulaziz university-medical sciences. 2010. 17 (2). 37–54. DOI: 10.4197/Med.17-2.4
18. Graudina V. E., Zulfigarova B. T., Kostina I. V., Ausheva F. I., Botez L. S. Anomaly of development of branches of the aortic arch with complete STEAL syndrome: a clinical case of a rare diagnostic finding // International journal of heart and vascular diseases. 2022. 10 (33). 39–46. (In Russian).
19. Kniga V. V., Biruyukbava G. N., Kuz`mina A. Yu. Prevalence of vertebral artery hypoplasia and its clinical significance in pilots of the older age group // Lechashchiy vrach. 2016. 7. 28–32. (In Russian).
20. Shin Y., Chung Y., Shin W. H, Im S. B., Hwang S. C., Kim B. T. A morphometric study on cadaveric aortic arch and its major branches in 25 Korean adults: the perspective of endovascular surgery // Journal of Korean neurosurgical society. 2008. 44 (2). 78–83. DOI: 10.3340/jkns.2008.44.2.78
21. Каn I. V., Samotesov P. А., Levenets А. А. Constitutional features of the structure of the main vessels of the neck of men // Siberian Medical Review. 2011.2 (68). 51–54. (In Russian).
22. Barral J.-P., Croibier A. Visceral Vascular Manipulations. Oxford: Churchill Livingstone, Elsevier, 2011. 269 p.
23. Junagade B., Mukherjee A. The morphometric study of the normal and variant branching pattern of the Aortic arch by cadaveric dissection // International journal of medical research & review. 2015. 3 (5). 461–469. DOI: 10.17511/ijmrr.2015.i5.090
24. Karacan A., Türkvatan А., Karacan К. Anatomical variations of aortic arch branching: evaluation with computed tomographic angiography // Cardiology in the young. 2014. 24 (3). 485–493. DOI: 10.1017/S1047951113000656
25. Açar G., Çiçekcibaşı A. E., Uysal E., Koplay M. Anatomical variations of the aortic arch branching pattern using CT angiography: a proposal for a different morphological classification with clinical relevance // Anatomical Science International. 2022. 97 (1). 65–78. DOI: 10.1007/s12565-021-00627-6
26. Açar M., Ulusoy M., Zararsiz I., Efe D. Anatomical variations in the branching of human aortic arch // Biomedical research. 2013. 24 (4). 531–535.
27. Pandalai U., Pillay M., Moorthy S., Sukumaran T. T., Ramakrishman S., Gopalakrishnan A., Krishnan A., Pillai A. K. G. Anatomical variations of the aortic arch: a computerized tomography-based study // Cureus. 2021. 13 (2). e13115. DOI: 10.7759/cureus.13115
28. Ogengo’o J. A., Olabu B. O., Gatonga P. M., Munguti J. K. Branching pattern of aortic arch in a Kenyan population // Journal of morphological sciences. 2010. 27 (2). 51–55.
29. Rekha P., Senthilkumar S. A study on branching pattern of human aortic arch and its variations in South Indian population // Journal of morphological sciences. 2013. 30 (1). 11–15.
30. Yousef S., Singh S., Alkukhun A., Alturkmani B., Mori M., Chen J., Mullan C. W., Brooks C. W., Assi R., Gruber P. J., Cortopassi I., Geirsson A., Vallabhajosyula P. Variants of the aortic arch in adult general population and their association with thoracic aortic aneurysm disease // Journal of cardiac surgery. 2021. 36 (7). 2348–2354. DOI: 10.1111/jocs.15563
31. Bhatia K., Gabriel M. N., Henneberg M. Anatomical variations in the branches of the human aortic arch: a recent study of a south Australian population // Folia morphologica (warsz). 2005. 64 (3). 217–223.
Review
For citations:
Murashov O.V., Ivanova N.V., Komandresova T.M., Begun M.S., Nasedkin A.G., Ishchenko O.S., Luppo M.D. A rare case of double variation of the aortic arch («bovine arch» and aberrant left vertebral artery). Title in english. 2025;(2(140)):191-202. (In Russ.) https://doi.org/10.34680/2076-8052.2025.2(140).191-202