A case report that identifies a rare aortic arch variation in a cadaveric donor: Simultaneous brachiocephalico-carotid trunk and direct origin of the left vertebral artery

The most prevalent aortic arch (AA) branching pattern consists of three distinct vessels that arise from the AA: the brachiocephalic trunk (BCT), left common carotid artery (LCCA), and left subclavian artery (LSA). Variations in this typical branching pattern are common, but very few cases have been documented where two variations coincide. Here we report a case of a simultaneous brachiocephalico- carotid trunk (BCCT) and direct origin of the LVA identified in a 92-year-old male cadaver during routine educational dissection. The embryological formation and clinical significance of this combined AA variation are discussed. This variation is typically asymptomatic, but can increase the risk of complications during clinical interventions if not recognized. Understanding its embryological development can help explain this rare variant and highlight the importance of accurately identifying and classifying it in clinical settings.