Computed Tomographic Analysis of Aortic Arch Branching Patterns - Revisited

Background /ObjectivesBranching pattern of aortic arch (AA) has a direct impact on the outcome of thoracic surgical and angiographic procedures. Geographical variations in the branching pattern of AA has been described. Hence, this descriptive cross sectional study describes the AA variations in a Sri Lankan population compared to the available global statistics.MethodsContrast-enhanced computed tomographic studies (CTC) of thorax (n=219) performed in males (49.3%) and females (50.7%); aged 59±17 years (range: 4 to 96 years), were evaluated. Branching patterns of AA were categorized into seven types as described by Popieluszko et al.ResultsFour AA types were identified in the study population: Type 1 (90%; n=197), Type 2 (n=10, 4.6%), Type 3 (n=8, 3.7%) and Type 6 AA (n=4; 1.8%). The prevalence of AA variations was 10%. Type 1 was the most prevalent pattern in both genders: female-91%; males-88.9%. The most prevalent AA variant in females was Type 2 (n=6; 5.4%); males Type 3 (n=5; 4.6%). However, the branching pattern of AA has not demonstrated a significant gender influence (Odds: 0.792; 95% CI: 0.327 - 1.917; p=0.605). ConclusionVariations in branching pattern of AA is as high as 10% among Sri Lankans. Thus, an in-depth knowledge on population specific prevalence of AA variants would influence the modifications surgical approaches and the choice of angiographic catheters to be utilized, which in turn, would minimize inadvertent vascular injuries during thoracic surgical and angiographic interventions.