6. Tronco común de la a. subescapular y la
circunfleja humeral post.
A. toracodorsal naciendo directamente de la
a. axilar
Ausencia de la a. torácica lateral
A. braquial accesoria
Variante superficial de la a. braquial, radial o
ulnar
Origen braquial o axilar de la a. radial y
ulnar
7. 1. D'Souza D, Yap J, Anan R, et al. Variant anatomy of the aortic arch. Reference
article, Radiopaedia.org (Accesado 15 feb 2023) https://doi.org/10.53347/rID-917
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Notas del editor
A bovine arch is present in ~15% (range 8-25%) of the population and is more common in individuals of African descent.
A bovine arch branching pattern is described as a common origin of the brachiocephalic artery and the left common carotid artery. The left subclavian artery arises independently from the more distal arch.
This common variant is asymptomatic most of the time. In rare cases of head and neck surgery, e.g. tracheostomy, it can be a risk factor for injury and cause complications.
Given the challenges in catheterization, it is perhaps unsurprising that the main clinical relevance of a bovine arch is an increase in complications reported during interventional procedures.
Some authors, highlighting that the bovine arch pattern is not the normal aortic branching pattern found in bovines, concluded the arrangement described as "a bovine arch" is a misnomer. Their preferred terminology is "common origin of the brachiocephalic artery and left common carotid artery”.
In the case of the bovine arch, the 180° angle of the bifurcation resembles the 180° angle of the horns of a bovine. This is the likely origin of the term "bovine arch".
True bovine arch: common origin of all four aortic arch vessels; the most common arrangement in bovines but very rare in humans
Double aortic arches are the most common symptomatic type of the aortic arch variant. It may account for up to 50-60% of vascular rings.
https://www.researchgate.net/figure/The-anatomy-of-the-right-aortic-arch-with-mirror-image-branching-DA-14-descending-aorta_fig3_51747906
https://www.researchgate.net/figure/The-anatomy-of-the-right-aortic-arch-with-aberrant-left-subclavian-artery-LCA-14-left_fig2_51747906
LIA: left innominant artery
Right-sided aortic arch is a type of aortic arch variant characterized by the aortic arch coursing to the right of the trachea
A right-sided aortic arch is thought to occur in approximately ~0.1% (range 0.05-0.2%) of the population. There is a significant association with 22q11.2 deletion syndrome (DiGeorge syndrome).
Type I: right-sided aortic arch with mirror image branching
Type II: right-sided aortic arch with aberrant left subclavian artery
Type III: right-sided aortic arch with isolation of the left subclavian artery
Kommerell diverticula occur in some anomalies of the aortic arch system. It usually refers to the bulbous configuration of the origin of an aberrant left subclavian artery in the setting of a right-sided aortic arch. However, it was originally described as a diverticular outpouching at the origin of an aberrant right subclavian artery with a left-sided aortic arch.
Also known as arteria lusoria, are among the commonest aortic arch anomalies.
The estimated incidence is 0.5-2%
The word lusoria comes from the Latin phrase "lusus naturae", meaning "freak of nature", which refers to the anomalous course of the artery
The most common variant from the subclavian artery is the aberrant right subclavian artery.
They are often asymptomatic, but ~10% of people may complain of tracheo-esophageal symptoms, almost always as dysphagia, termed dysphagia lusoria
80% posterior to the esophagus
15% between esophagus and trachea
5% anterior to the trachea
Other variations of the subclavian artery:
Other variations occur with branching patterns. If the inferior thyroid artery arises from it (instead of the normal origin of from the thyrocervical trunk), it is known as the accessory inferior thyroid artery.
https://radiopaedia.org/articles/axillary-artery
https://radiopaedia.org/articles/brachial-artery
Origen alto de la arteria radial = arteria braquioradial
Otras variantes:
Arco aórtico cervical
Aorta circunfleja
Arteria tiroidea ima
Origen de la arteria vertebral directamente del arco aortico
Arteria tiroidea inferior naciendo directamente de la arteria subclavia
Arteria intercostal suprema (https://radiopaedia.org/articles/supreme-intercostal-arteries)
Ausencia de la arteria torácica lateral
https://radiopaedia.org/articles/variant-anatomy-of-the-aortic-arch
