Anatomical variation of the trajectory of the brachiocephalic artery encountered during parathyroid adenoma excision. A rare case report and a surgical challenge

Zarokosta, Maria; Piperos, Τheodoros; Chrysikos, Dimosthenis; Patrinos, Antonios; Kakaviatos, Dimosthenis; Kalles, Vassileios; Papapanagiotou, Ioannis; Tsiaoussis, John; Theodoropoulos, Panagiotis; Mariolis‐Sapsakos, Theodoros

doi:10.1016/j.ijscr.2019.04.007

Cited by 4 publications

(3 citation statements)

References 9 publications

(25 reference statements)

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“…Anatomical variations of the BCA are of paramount clinical significance since they constitute major risk-factors of accidental haemorrhage when performing Tracheotomy, surgeries of the thyroid and parathyroid glands, in the tumor excision of the neck and invasive radiology. 8 Brachiocephalic artery injury is the primary cause of fatal haemorrhage in tracheostomized patients due to establishment of a tracheo-vascular fistula and this arterial bleeding accounts for 59.3% of the cases. 34 Although, the prevalence of anatomical variations of the BCA reported in this study is low, their presence provides an insight on occurrence of BCA variants in a sample representative of African population (Ugandan population) of which the surgeons should pay attention when performing surgeries of the thoracic cavity and anterior of the neck.…”

Section: Discussionmentioning

confidence: 99%

“…6 The most clinically significant complication associated with Brachiocephalic artery variations includes fatal perioperative and postoperative hemorrhage that entails escape of blood from blood vessels as a result of injury through the vessel. 7 Hemorrhage is a feared complication of Tracheostomy and can present during Tracheostomy 8 or anytime during the following three weeks of Tracheostomy due to formation of tracheoinominate fistula as a result of friction between the Tracheostomy tube and the surface of Brachiocephalic artery. 9 The Brachiocephalic artery is anteriorly related to the trachea.…”

Section: Introductionmentioning

confidence: 99%

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Anatomical variations of the brachiocephalic artery and their clinical relevances: A cadaveric study of Ugandan population

Tito,

Obeten,

Archibong

et al. 2024

IJCAP

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The study examined variations in morphology and morphometry of the brachiocephalic artery and their clinical implications in dissected cadavers. Fifty-eight (58) adult cadavers, 57 males and 1 female were dissected to expose the brachiocephalic artery, and the morphological and morphometric variations were recorded.Fifty-one (51) cadavers (88%) had the BCA arising directly from the aortic arch while 7 cadavers (12%) had it originating from the common trunk with the left common carotid artery. The BCA arose on the left anterolateral to the trachea in 57 cadavers (98.3%) and one cadaver (1.7%) had it arising in the midline anterior to the trachea crossed the trachea from left to right terminating posterior to the right sternoclavicular joint where it bifurcated into the right subclavian and right common carotid artery in all cadavers. The mean lengths of the torsos and Brachiocephalic arteries were 45.78±2.93cm and 4.14±0.58cm respectively and the two parameters had statistically significant positive correlation (r=0.33, p<0.05).: A majority of the Ugandan cadaveric population have brachiocephalic arteries with the normal origin, course, and branching patterns. The occurrence of origin variants of BCA from the common trunk and anterior midline to the trachea may be associated with tracheal compression and aortic dilation; hence should be considered as a potential risk factor for thoracic aortic aneurysm and during tracheostomy respectively.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Anatomical variations of the brachiocephalic artery and their clinical relevances: A cadaveric study of Ugandan population

Tito,

Obeten,

Archibong

et al. 2024

IJCAP

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“…Additionally, we encountered 8 cadaveric reports of aberrant brachiocephalic arterial anatomy. [35][36][37][38][39][40][41][42][43] There was an equal predominance of males and females in these studies. There were 3 bovine anomalies reported-all in male cadavers and all arising from the right of the midline-as well as 2 sub-isthmic BCA, and 3 high-riding BCA.…”

Section: Summary Of Case Reportsmentioning

confidence: 99%

Vascular Variations in the Central Neck and Their Implications on Tracheostomy: Literature Review and Case Report

McEwen

Hoffman

2022

FACE

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Tracheostomy is a commonly performed procedure in the setting of head and neck cancer surgery, and generally performed with minimal morbidity and mortality. Iatrogenic injury to the brachiocephalic artery is an extremely rare event that can occur during the undertaking of a tracheostomy. Aberrant vascular anatomy can predispose to this catastrophic complication. Although not frequently encountered in clinical practice, vascular anomalies of the aortic arch branches can occur in up to 20% of the population. This review of the literature discusses the common branching, positional, and numerical variations of the aortic—brachiocephalic arterial anatomy in the root and central neck, and the implications of these vascular variants on the undertaking of a routine tracheostomy. The authors outline a case of catastrophic hemorrhage during a routine trache xostomy in a 69-year-old patient with a bovine aortic arch anomaly. The intraoperative sequalae, emergency management, imaging findings, and future implications of such an occurrence are discussed. The paper provides a timely reminder to surgeons to raise awareness of the variability of the vascular anatomy in the neck and the operative implications of surgical undertakings in the root of the neck.

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Beware of the High Brachiocephalic Artery Presenting as Neck Mass: a Case Report and Review of Literature

Karmakar

Mishra

Jain³

2021

Indian J Surg

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Anatomical variation of the trajectory of the brachiocephalic artery encountered during parathyroid adenoma excision. A rare case report and a surgical challenge

Cited by 4 publications

References 9 publications

Anatomical variations of the brachiocephalic artery and their clinical relevances: A cadaveric study of Ugandan population

Anatomical variations of the brachiocephalic artery and their clinical relevances: A cadaveric study of Ugandan population

Vascular Variations in the Central Neck and Their Implications on Tracheostomy: Literature Review and Case Report

Beware of the High Brachiocephalic Artery Presenting as Neck Mass: a Case Report and Review of Literature

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