Study on branching pattern of aortic arch in Indian.

Knowledge of the branching pattern of aortic arch is important during supra-aortic angiography, aortic instrumentation, thoracic and neck surgery. The purpose of this study is to describe different branching pattern of arch of aorta in Indian subjects, in order to offer useful data to anatomists, radiologists, vascular surgeons while relating it to the embryological basis. Seventy five arches of adult Indian cadavers were exposed and their branches examined during cadaveric dissection in the Department of Anatomy, Government Medical College, Nagpur. The usual three-branched aortic arch was found in 58 cadavers (77.3%); the 11 (14.66%) remaining aortic arch showed only two branches, out of which one was a common trunk, which incorporated the brachiocephalic trunk and left common carotid and other left subclavian artery and 6 (8%) aortic arches showed direct arch origin of the left vertebral artery. Although the variations are usually asymptomatic, they may cause dyspnoea, dysphasia, intermittent claudication, misinterpretation of radiological examinations and complications during neck and thorax surgery. Knowledge of different patterns of arch of aorta is critical when invading the arch of aorta and its branches by instruments, as all these areas are delicate.