A systematic review and meta-analysis of variations in branching patterns of the adult aortic arch
| Autor: | Wan Chin Hsieh, Przemysław A. Pękala, Beatrice Sanna, Karolina Saganiak, Krzysztof A. Tomaszewski, Patrick Popieluszko, Jerzy A. Walocha, Brandon Michael Henry |
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| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
0301 basic medicine
Thorax Aortic arch medicine.medical_specialty Population Cardiovascular Abnormalities Subclavian Artery Black People Aorta Thoracic 030204 cardiovascular system & hematology Asymptomatic 03 medical and health sciences 0302 clinical medicine medicine.artery medicine Prevalence Humans education Brachiocephalic Trunk Vertebral Artery education.field_of_study Aorta business.industry Incidence (epidemiology) Incidence Prognosis Trunk Aneurysm Surgery Carotid Arteries Meta-analysis 030101 anatomy & morphology Radiology medicine.symptom Cardiology and Cardiovascular Medicine business |
| Popis: | Objective The aortic arch (AA) is the main conduit of the left side of the heart, providing a blood supply to the head, neck, and upper limbs. As it travels through the thorax, the pattern in which it gives off the branches to supply these structures can vary. Variations of these branching patterns have been studied; however, a study providing a comprehensive incidence of these variations has not yet been conducted. The objective of this study was to perform a meta-analysis of all the studies that report prevalence data on AA variants and to provide incidence data on the most common variants. Methods A systematic search of online databases including PubMed, Embase, Scopus, ScienceDirect, Web of Science, SciELO, BIOSIS, and CNKI was performed for literature describing incidence of AA variations in adults. Studies including prevalence data on adult patients or cadavers were collected and their data analyzed. Results A total of 51 articles were included (N = 23,882 arches). Seven of the most common variants were analyzed. The most common variants found included the classic branching pattern, defined as a brachiocephalic trunk, a left common carotid, and a left subclavian artery (80.9%); the bovine arch variant (13.6%); and the left vertebral artery variant (2.8%). Compared by geographic data, bovine arch variants were noted to have a prevalence as high as 26.8% in African populations. Conclusions Although patients who have an AA variant are often asymptomatic, they compose a significant portion of the population of patients and pose a greater risk of hemorrhage and ischemia during surgery in the thorax. Because of the possibility of encountering such variants, it is prudent for surgeons to consider potential variations in planning procedures, especially of an endovascular nature, in the thorax. |
| Databáze: | OpenAIRE |
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