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Czasopismo

2010 | 69 | 4 |

Tytuł artykułu

Transverse subisthmic course of the innominate artery in an adult: detailed anatomy and additional variation

Warianty tytułu

Języki publikacji

EN

Abstrakty

EN
A rare morphology of an aberrant innominate artery (IA) is reported here, together with additional arterial variation encountered in the respective specimen. The IA originated in the aortic arch on the left side of the trachea, coursed on that side of the trachea to reach the left thyroid lobe, turned in at a right angle to pass anterior to the trachea and immediately inferior and parallel to the thyroid isthmus, and finally it divided inferior to the right thyroid lobe into the right subclavian and common carotid arteries. The right common carotid artery immediately turned at a right angle to ascend in the neck. Thus the terminal branches of the IA had origins in a higher position than is usually expected. This aberrant course of the IA determined a step-like morphology in the sagittal plane of the left common carotid artery. Additional variations were also encountered: (a) a lateralised right external carotid artery with the superior thyroid artery initially coursing over the internal carotid artery; (b) the right vertebral artery coursing over the inferior thyroid artery and entering the transverse process of the fifth cervical vertebra; (c) the left subclavian and vertebral arteries were tortuous. Knowledge of the presence of this IA variant, with a transverse subisthmic segment, appears to be important in various surgical approaches, such as tracheostomies, thyroidectomies, and mediastinoscopies; in addition, the variations of the IA and the vertebral arteries are relevant for lower cervical spine approaches. Nevertheless, the lateralised external carotid artery may lead, if unidentified, to hemorrhagic complications during carotid space approaches. It is important for surgeons to be aware that if an aberrant IA is identified it may not be the only variation in that patient. (Folia Morphol 2010; 69, 4: 261–266)

Wydawca

-

Czasopismo

Rocznik

Tom

69

Numer

4

Opis fizyczny

p.261-266,fig.,ref.

Twórcy

autor
  • Faculty of Dental Medicine, University of Medicine and Pharmacy "Carol Davila" 8, Bd.Eroilor Sanitari, RO-76241, Bucharest, Romania
autor
  • Faculty of Medicine, University of Medicine and Pharmacy "Victor Babes", Timisoara, Romania

Bibliografia

  • 1. Bhatia K, Ghabriel MN, Henneberg M (2005) Anatomical variations in the branches of the human aortic arch: a recent study of a South Australian population. Folia Morphol, 64: 217–223.
  • 2. Civelek E, Karasu A, Cansever T, Hepgul K, Kiris T, Sabanci A, Canbolat A (2008) Surgical anatomy of the cervical sympathetic trunk during anterolateral approach to cervical spine. Eur Spine J, 17: 991–995.
  • 3. Comert A, Comert E, Ozlugedik S, Kendir S, Tekdemir I (2004) High-located aberrant innominate artery: an unusual cause of serious hemorrhage of percutaneous tracheotomy. Am J Otolaryngol, 25: 368–369.
  • 4. Conoyer BM, Varvares MA, Cooper MH (2008) Right common carotid artery crossing the midline neck anterior to the trachea: a cadaver case report. Head Neck, 30: 1253–1256.
  • 5. Ebraheim NA, Lu J, Skie M, Heck BE, Yeasting RA (1997) Vulnerability of the recurrent laryngeal nerve in the anterior approach to the lower cervical spine. Spine, 22: 2664–2667.
  • 6. Fawcett SL, Gomez AC, Hughes JA, Set P (2010) Anatomical variation in the position of the brachiocephalic trunk (innominate artery) with respect to the trachea: a computed tomography-based study and literature review of innominate artery compression syndrome. Clin Anat, 23: 61–69.
  • 7. Hawkins JA, Bailey WW, Clark SM (1992) Innominate artery compression of the trachea. Treatment by reimplantation of the innominate artery. J Thorac Cardiovasc Surg, 103: 678–682.
  • 8. Maldjian PD, Saric M, Tsai SC (2007) High brachiocephalic artery: CT appearance and clinical implications. J Thorac Imag, 22: 192–194.
  • 9. Mukadam GA, Hoskins E (2002) Aberrant brachiocephalic artery precluding placement of tracheostomy. Anaesthesia, 57: 297–298.
  • 10. Rusu MC, Vasilescu A, Nimigean V (2006) A rare anatomic variant: the lateral position of the external carotid artery. Int J Oral Maxillofac Surg, 35: 1066–1067.
  • 11. Tubbs RS, Salter EG, Wellons JC 3rd, Blount JP, Oakes WJ (2005) The triangle of the vertebral artery. Neurosurgery, 56: 252–255.
  • 12. Upadhyaya PK, Bertellotti R, Laeeq A, Sugimoto J (2008) Beware of the aberrant innominate artery. Ann Thorac Surg, 85: 653–654.

Typ dokumentu

Bibliografia

Identyfikatory

Identyfikator YADDA

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