This report describes coexistence of anomalous branches of the aortic arch and the costocervical vein malformation in a German shepherd dog. The first branch of the aortic arch was a bicarotid trunk that divided into the left and right common carotid arteries. The next branch to leave the aortic arch was a common trunk for the right and left subclavian arteries, a bisubclavian trunk, which was immediately bifurcated. The right subclavian artery passed over the esophagus forming a deep groove, so-called incomplete vascular ring on the dorsal wall of the esophagus. Although the esophagus was constricted by the right subclavian artery dorsally and by the trachea ventrally, no clinical symptoms of esophageal obstruction and dysphagia were observed. The left costocervical vein coursed caudoventrally, passed over the aortic arch, and entered the left ventricle. This vessel was much smaller than the right costocervical vein and was partially occluded at its origin.
Animals ; Aorta, Thoracic/*abnormalities ; Carotid Artery, Common/abnormalities ; Dog Diseases/congenital/*pathology ; Dogs ; Fatal Outcome ; Female ; Subclavian Artery/abnormalities ; Veins/*abnormalities

We present here two patients that had an aberrant right subclavian artery and an anomalous origin of the right vertebral artery from the right common carotid artery. We review the previous literature and discuss herein the embryologic mechanism and clinical implications of this variation.
Adult ; Aged ; Carotid Artery, Common/*abnormalities/radiography ; Female ; Humans ; Male ; Subclavian Artery/*abnormalities/radiography ; Tomography, X-Ray Computed ; Vertebral Artery/*abnormalities/radiography

OBJECTIVE: Duplication of the vertebral artery (VA) is a rare vascular variant. This paper describes the anatomy and embryological development of duplicated VAs and reviews the clinical significance.METHODS: Computed tomography (CT) angiography was performed in 3386 patients (1880 females, 1506 males) between March 2014 and November 2015. We defined duplication of the VA as a condition in which the VA has two origins that fused at different levels of the neck.RESULTS: Ten of the 3386 patients (0.295%) who received CT angiography had a dual origin of the VA; three on the left side, and seven on the right side. In all seven with right dual origin of the VA, both limbs of the VA origin originated from the right subclavian artery. In all three patients with left dual origin of the VA, both limbs of the VA originated from the left subclavian artery and aortic arch. In all 10 patients, the medial limb of the duplicated VA was located posteriorly and medially to the common carotid artery (CCA) and anteriorly and laterally to the vertebral transverse foramen. In two patients, the medial limb of the duplicated VA was located in close proximity to the CCA. In another two patients, the medial limb of the duplicated VA was located in close proximity to the CCA, carotid bifurcation, and proximal internal carotid artery.CONCLUSION: Although duplication of the VA is asymptomatic in most patients, clinicians should consider this anomaly during diagnosis and treatment.
Angiography ; Aorta, Thoracic ; Carotid Artery, Common ; Carotid Artery, Internal ; Congenital Abnormalities ; Diagnosis ; Embryonic Development ; Extremities ; Female ; Humans ; Neck ; Pregnancy ; Subclavian Artery ; Vertebral Artery

Anatomical variations of carotid arteries may be related to their development (agenesis, aplasia, hypoplasia) or course (coiling, kinking, tortuosity). Partial or total aberrancies in carotid vessel anatomy rarely occur. We describe the case of a 95-year-old woman presented with sudden onset of confusion and disorientation together with upper limb clonus. Computed tomography (CT)-scan revealed a left frontal brain injury with a not conclusive carotid doppler ultrasound. CT angiography reported a bovine aortic arch with bilateral retroesophageal course of both common carotid arteries and left severe (>70%) internal carotid artery stenosis. The knowledge of anatomical variations of the course of carotid arteries is relevant for possible surgical or endovascular repair or in case of otolaryngology or intubation procedures.
Angiography ; Aorta, Thoracic* ; Brain Injuries ; Cardiovascular Abnormalities ; Carotid Arteries ; Carotid Artery, Common* ; Carotid Stenosis ; Female ; Humans ; Intubation ; Otolaryngology ; Ultrasonography ; Upper Extremity

The aortic arch gives rise to three classical branches, namely the brachiocephalic trunk, the left common carotid artery and the left subclavian artery. We report a rare variation of the left common carotid artery and the right vertebral arteries originating from the brachiocephalic trunk, and the left vertebral artery that was arising from the arch of the aorta, proximal to the origin of the left subclavian artery. Variations in the branching pattern of the arch of aorta can alter the cerebral haemodynamics that leads to cerebral abnormalities. Knowledge of the variations in the classical branches of the arch of aorta is important in the diagnosis of intracranial aneurysm after subarachnoid haemorrhage.
Aorta, Thoracic ; abnormalities ; pathology ; Brachiocephalic Trunk ; abnormalities ; anatomy & histology ; Cadaver ; Carotid Artery, Common ; abnormalities ; anatomy & histology ; Humans ; Male ; Middle Aged ; Subclavian Artery ; abnormalities ; anatomy & histology ; Vertebral Artery ; abnormalities ; anatomy & histology

Aberrant right subclavian artery (ARSA) is a congenital anomaly that usually does not produce symptoms. However, patients with symptoms may require surgical intervention. Surgical procedures consist of division of ARSA from the descending aorta and reimplantation to the right common carotid artery or ascending aorta. Specific anesthetic management includes invasive monitoring of blood pressure in both radial arteries, monitoring of adequate cerebral perfusion, and ventilatory strategy to facilitate surgical exposure. Although many reports are available regarding its surgical treatment, there are few reports, to the author's best knowledge, that describe anesthetic management for its surgical correction. This case report will focus on important aspects of the anesthetic management of patients with ARSA.
Anesthesia ; Aneurysm ; Aorta ; Aorta, Thoracic ; Blood Pressure ; Cardiovascular Abnormalities ; Carotid Artery, Common ; Deglutition Disorders ; Humans ; Perfusion ; Radial Artery ; Replantation ; Subclavian Artery

A 53-year-old woman had right aortic arch, Kommerell's diverticulum and aberrant left subclavian artery (LSA) without any compressive symptoms. Hybrid operation was performed. This consisted of LSA bypass using a 6 mm ringed Gore-Tex graft between the left common carotid artery and aberrant LSA via a left supraclavicular incision, and stent graft insertion into the aortic arch via the right femoral artery. Postoperative computed tomography as well as intraoperative angiography demonstrated successful occlusion of Kommerell's diverticulum and bypass of the aberrant LSA. There were no complications related to the operation or the intervention.
Aneurysm ; Angiography ; Aorta, Thoracic ; Cardiovascular Abnormalities ; Carotid Artery, Common ; Chimera ; Deglutition Disorders ; Diverticulum ; Female ; Femoral Artery ; Humans ; Middle Aged ; Polytetrafluoroethylene ; Stents ; Subclavian Artery ; Transplants

Angioplasty, Balloon, Coronary ; Bradycardia ; etiology ; Cardiac Pacing, Artificial ; adverse effects ; Carotid Artery, Common ; abnormalities ; Heart Block ; etiology ; Humans ; Jugular Veins ; abnormalities ; Male ; Middle Aged ; Shock, Cardiogenic ; etiology ; Thromboembolism ; complications ; Torsades de Pointes ; etiology