Takeoff orientation of the major aortic arch branches irrespective of arch type: Ramifications for brachiocephalic interventions including carotid stenting

SAGE Open Medicine
Rajiv TayalNajam Wasty

Abstract

Our previous work demonstrating great ease and predictability of cannulation of the major aortic arch branches with an upwardly pointing 3DR catheter, irrespective of aortic arch type, led us to hypothesize that centering or "cresting" of these vessels must occur along the superior most aspect of the aortic arch in a curvilinear fashion. We retrospectively analyzed 111 computed tomographic scans of the chest and thoracic aorta with intravenous contrast performed at our hospital between April 2011 and May 2012 utilizing TeraRecon image reconstruction software. Four studies were excluded due to poor image quality and/or surgical changes to native aortic architecture. Of the 107 studies included, 104 (97.2%) demonstrated centering of the major aortic arch branches on a curvilinear line "cresting" the superior most aspect of the aortic arch irrespective of arch type. Of the three studies that did not demonstrate this "cresting," two were found to have aberrant right subclavian arteries associated with a type I aortic arch, and one had an aberrant right common carotid associated with a type II aortic arch. Operators engaging major aortic arch branches need to be mindful of the fact that these vessels are indeed centered on a line "c...Continue Reading

References

Oct 4, 2005·Annals of Vascular Surgery·Stephanie C LinPeter L Faries
Jun 14, 2006·Archives of Neurology·Pooja Khatri, Scott E Kasner
Jan 24, 2007·European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery·G L FaggioliA Stella
May 1, 2007·Journal of Vascular Surgery·Russell C LamPeter L Faries
Apr 5, 2008·Stroke; a Journal of Cerebral Circulation·Sonja SchnaudigelAndreas Kastrup
Sep 9, 2010·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Najam WastyRamzan M Zakir
Oct 29, 2010·Journal of Anatomy·Stefanos DemertzisJos Van den Berg
Sep 16, 2015·European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery·H B AlbertaJ S Matsumura

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Software Mentioned

SPSS
TeraRecon

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