Prevalence of common origin of the innominate and left carotid artery or bovine arch configuration in patients with blunt aortic injury.

BACKGROUND

The common origin of the innominate and left carotid artery (CILCA) have been described as a risk factor for thoracic aortic diseases (dissections and aneurysms), but its relationship with traumatic pathology of the thoracic aorta is not so well known. The aim of the present study is to describe the prevalence of CILCA among patients admitted to the hospital for high-energy polytrauma with aortic injury (BTAI) compared with a control group.

METHODS

Retrospective unicenter case-control study. Cases included all patients treated with BTAI between 1999-2020. The group of controls was patients admitted in our center for high-energy polytrauma between 2012-2017. Primary endpoint was to define the prevalence of CILCA among both groups and secondary endpoint was to measure the distance between brachiocephalic trunk (BCT) or left common carotid artery (LCCA) and left subclavian artery (LSA). Results were retrospectively reviewed by two investigators.

RESULTS

Forty-nine patients in BTAI group and 248 patients in control group. With a good concordance between investigators, 21 patients with CILCA (42.9%) in the BTAI group versus 61 CILCA (24.6%) in the control group (P=0.009). The mean distance between BCT/LCCA and LSA among the cases with CILCA was 10.09 mm (SD=2.89) and 7.48 mm (SD=3.65) among cases with standard aortic arch (P=0.010).

CONCLUSIONS

In the present study we found that CILCA configuration is more prevalent in patients with BTAI and the distance to left subclavian artery is longer.