Diseases of the Aortic Arch and Brachiocephalic Arteries

PREVIOUS STUDIES 1-4 have disclosed structural changes of preferential location in the aortic arch and in the brachiocephalic arteries in aged persons. They are situated in the internal carotid artery, right and left, immediately cranial to or at its origin from the common carotid artery; in the right subclavian artery at its origin from the innominate artery; and in the aortic arch at the levels of the origin of the innominate artery, the origin of the left subclavian artery, and the insertion of the ligamentum arteriosum (Fig 1, 1-6).They consist of calcified foci, radiographically demonstrable, and intimai depressions at the levels of the calcifications, often with corresponding protrusions on the adventitial surface of the media, visible on direct inspection. These areas show increased translucency when viewed by the transillumination. Atheromatous plaques of varying sizes, together with varying degrees of stenosis, form at these levels. Histological examination confirms the presence of atherosclerosis with fibrous intimai