Introduction
Aortic arch anomalies constitute a broad spectrum of congenital variants
of the development of the aortic arch and great vessels. During
embryology, bilateral ventral and dorsal aortae are connected by arches,
most of them regress except for the 3rd arch that
gives rise to the carotid arteries, the 4th arch that
gives rise to the adult arch, and the 6th arch that
gives rise to the ductus arteriosus 1. Due to this
complex developmental process, variations or anomalies of the arch and
its branches may occur 2. Anomalies of the origin of
arch vessels include common origin of the left common carotid and the
brachiocephalic arteries (bovine arch) 3, aberrant
origin of the right and left subclavian arteries from the descending
aorta that sometimes originate from a localized dilatation called
Kommerell’s diverticulum 4,5, and aberrant
origin of the left vertebral artery from the arch itself rather than
originating from the left subclavian artery 6.
Anomalies of the laterality and position of the arch includes double
arch, right sided arch, circumflex arch, cervical arch, interrupted
arch, and pseudocoarctation 7,8. Some variants are
reported to be very common in the general population, with example
bovine arch reported to have a prevalence of ~20%,
while other variants such as double and cervical arch patterns are rare2. It has been reported that arch anomalies are
associated with increased incidence of congenital heart disease9 and also thoracic aortopathies 10,
although large population studies on arch anomalies are lacking. We
assessed our institutional CT scan database to better understand the
prevalence of arch anomalies in the older adult population age> 50 years, and its possible association with the
thoracic aortic aneurysm disease.