Shin Il-Young, Chung Yong-Gu, Shin Won-Han, Im Soo-Bin, Hwang Sun-Chul, Kim Bum-Tae
Department of Neurosurgery , Korea University Anam Medical Center, Seoul, Korea.
J Korean Neurosurg Soc. 2008 Aug;44(2):78-83. doi: 10.3340/jkns.2008.44.2.78. Epub 2008 Aug 30.
To understand the anatomic characteristics of the aortic arch (AA) and its major branches to build a foundation toward performing endovascular surgery safely.
A total of 25 formalin fixed Korean adult cadavers were used. The authors investigated : anatomical variations of the AA and its major branches; curvature of the AA; distance from the mid-vertebrae line to the origin of the major branches; distances from the origin of the major branches of AA to the origin of its distal branches; and the angle of the three major branches, the brachiocephalic trunk (BCT), the left common carotid artery (LCCA) and the left subclavian artery (LSCA) arising from AA.
The three major branches directly originated from AA in 21 (84%) of the cadavers. In two (8%) of remaining four cadavers, orifice of LCCA was slightly above the stem of BCT. In remaining two (8%) cadavers, the left vertebral artery (LVA) was directly originated from AA. Average angle of AA curvature to the coronal plane was 62.2 degrees. BCT originated 0.92 mm on the right of the mid-vertebrae line. LCCA and LSCA originated from 12.3 mm and 22.8 mm on the left of the mid-vertebrae line. Mean distance from the origin of the BCT to the origin of the RCCA was 32.5 mm. Mean distance from the origin of the LSCA to the origin of the LVA was 33.8 mm. Average angles at which the major branches arise from the AA were 65.3, 46.9 and 63.8 degrees.
This study may provides a basic anatomical information to catheterize AA and its branches for safely performing endovascular surgery.
了解主动脉弓(AA)及其主要分支的解剖特征,为安全开展血管内手术奠定基础。
共使用25具经福尔马林固定的韩国成年尸体。作者研究了:AA及其主要分支的解剖变异;AA的曲率;从椎体中线到主要分支起点的距离;从AA主要分支起点到其远端分支起点的距离;以及AA的三个主要分支,即头臂干(BCT)、左颈总动脉(LCCA)和左锁骨下动脉(LSCA)的夹角。
21具(84%)尸体的三个主要分支直接起源于AA。其余4具尸体中有2具(8%),LCCA的开口略高于BCT的主干。在其余2具(8%)尸体中,左椎动脉(LVA)直接起源于AA。AA曲率与冠状面的平均夹角为62.2度。BCT起源于椎体中线右侧0.92毫米处。LCCA和LSCA分别起源于椎体中线左侧12.3毫米和22.8毫米处。从BCT起点到右颈总动脉(RCCA)起点的平均距离为32.5毫米。从LSCA起点到LVA起点的平均距离为33.8毫米。主要分支从AA发出的平均角度分别为65.3度、46.9度和63.8度。
本研究可为安全进行血管内手术时对AA及其分支进行插管提供基本解剖学信息。