Aortic Arch Anomalies are Associated with Increased Risk of Neurological Events in Carotid Stent Procedures

Abstract

Aortic arch anomalies are not infrequent and are associated with increased risk of neurological complications. The indication for CAS should be carefully evaluated in these cases.

‘Bovine’ Aortic Arch – A Marker for Thoracic Aortic Disease

“…BA is typically regarded as a ‘normal,’ clinically insignificant anatomic variant, often incidentally discovered on thoracic imaging studies or during thoracic surgery. The variant has been reported relatively frequently in patients with traumatic aortic injury [16,17] and may be associated with complications in carotid stenting procedures [18,19,20]. Clinicians have noted in general terms that BA is fairly common in patients with thoracic aortic aneurysm (TAA) – BA is often encountered intraoperatively in patients undergoing aortic surgery – but this relationship has not been thoroughly investigated.…”

Carotid artery stenting in difficult aortic arch anatomy with or without a new dedicated guiding catheter: preliminary experience

“…Anatomical variants of the supra-aortic vessel take-off and course are frequent and may increase the technical difficulties and related complications of CAS [24].…”

“…Unfavourable complex anatomy and congenital anomalies of the supra-aortic vessel take-off increase the technical difficulties and periprocedural complications of CAS [24,25].…”

Letter to the Editor re: “Carotid stenting through the right brachial approach for left internal carotid artery stenosis and bovine aortic arch configuration”

“…[1] and others [12][13][14][15][16], the presence of a bovine aortic arch has significant clinical implications. It is important to be aware of specific characteristics of the bovine arch, including the angle of origin of the left common carotid and innominate arteries.…”