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Case Reports
. 2015 Jul;9(7):AD05-7.
doi: 10.7860/JCDR/2015/14219.6253. Epub 2015 Jul 1.

Two Common Trunks Arising From Arch of Aorta: Case Report and Literature Review of A Very Rare Variation

C S Ramesh Babu  1 , Vinay Sharma  2
Affiliations
Case Reports

Two Common Trunks Arising From Arch of Aorta: Case Report and Literature Review of A Very Rare Variation

C S Ramesh Babu et al. J Clin Diagn Res. 2015 Jul.

Abstract

Arch of aorta normally gives off three branches, the brachiocephalic trunk, left common carotid artery and left subclavian artery. Due to its complex development, variations in the branching pattern are not infrequent and since many such variants remain asymptomatic, they are detected incidentally at diagnostic imaging, autopsy and surgery. The classical branching pattern is reported to be present in 63.5%-89.4% cases and the most common variant observed is the presence of common trunk of brachiocephalic and left common carotid arteries. Direct aortic arch origin of left vertebral artery is the second most common pattern observed. We report here an extremely rare branching pattern of two common trunks arising from the arch, the first common trunk of brachiocephalic and left common carotid arteries and the second designated as vertebro-subclavian trunk, the common trunk of origin of left subclavian and left vertebral arteries. To the best of our knowledge this is the second such case to be reported.

Keywords: Bovine aortic arch; Variant branching pattern; Vertebro-subclavian trunk.

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Figures

[Table/Fig-1A-C]:
[Table/Fig-1A-C]:
[A] Dissection of mediastinum and root of neck with heart in situ showing the origin of two common trunks from arch of aorta. [B] Aortic lumen showing two atheromatous plaques (arrow) close to the ostia of the two common trunks. [C] Showing the common trunk from arch of aorta dividing into brachiocephalic trunk (BCT) and left common carotid artery (LCCA) and BCT dividing into right common carotid and subclavian arteries. The vertebro-subclavian truk (VST) is dividing into left vertebral (LVA) and left subclavian arteries (LSA).
[Table/Fig-2]:
[Table/Fig-2]:
Arch of aorta showing the origin of two common trunks, the first common trunk dividing into brachiocephalic trunk (BCT) and left common carotid artery (LCCA) and the second giving origin to left vertebral artery (LVA) and left subclavian artery (LSA)
[Table/Fig-3]:
[Table/Fig-3]:
Lumen of arch of aorta showing only two ostia; the first, ostium of common trunk giving origin to brachiocephalic trunk (green probe, BCT) and left common carotid artery (red probe, LCCA) and a second ostium of vertebro-subclavian trunk (VST)
See this image and copyright information in PMC

References

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