# Variations in the Branching Pattern of the Aortic Arch Among Adults and Its Clinical Correlations: A Computed Tomographic Angiographic Study

## TL;DR

This study examines variations in the aortic arch's branching pattern in adults and their clinical implications using CT angiography.

## Contribution

The study is the first of its kind conducted in the Himalayan belt of North India, focusing on aortic arch variations.

## Key findings

- 15% of patients with aortic arch variations experienced dyspnea.
- 40% of patients had the left common carotid artery originate from the brachiocephalic trunk.
- Variations in aortic arch branching were found to be clinically relevant for surgical planning.

## Abstract

Background: Variations can occur in the branching pattern of the aortic arch (AA) because of its complex embryological development. These variations are quite common and typically asymptomatic but can sometimes cause dyspnea, dysphagia, and intermittent claudication, as well as confusion in the interpretation of radiological scans.

Methods: In the present study, we analyzed the types and incidence of AA variations in 105 patients after careful computed tomographic angiographic (CTA) imaging.

Results: In the present study, we found that out of the 20 patients, three with variations in the branching pattern of the AA had experienced dyspnea (15%). The left common carotid artery (CCA) originated from the brachiocephalic trunk (BCT) in eight out of 20 patients (40%). The left vertebral artery (VA) originated from the AA in five (25%) patients. The thyroid ima artery (TIA) originated from the BCT in two participants (10%). The left CCA and BCT originated from the AA as a single trunk in two patients (10%). The left VA originated from the AA and the right VA from the BCT in one patient (5%). The BCT originated as the left branch from the AA in one patient (5%). The right and left CCA originated as a single trunk from the AA in one patient (5%).

Conclusion: The present prospective study is the first conducted in the Himalayan belt of North India. The findings highlight the importance of spreading awareness about variations in the branching pattern of the AA. This awareness is useful when executing endovascular procedures and planning cardiothoracic surgeries.