vertebral artery is the first branch of subclavian artery. it merges with the same artery of the opposite side to form basilar artery and becomes one of the important source of blood supply to the brain. variation in the origin of left vertebral artery was found in 65 year old female during magnetic resonance angiography of the neck vessels. it originated from aortic arch and was longer as comp...

Conventional surgical treatment of a ruptured aortic arch aneurysm is a challenging approach with a high rate of adverse outcomes. The midsternotomy can be complicated by total aortic disruption with often fatal massive hemorrhage. A preliminary cardiopulmonary bypass with peripheral cannulation and cooling is often preferred. Endovascular stents have been used in patients with thoraco-abdomina...

In prenatal and pediatric cardiovascular surgery knowledge of the various arrangements of the aortic arch and its branches as well as the normative data are essential. The variability and morphometric features of the brachiocephalic trunk in 131 human foetuses (65 male, 66 female) ranging from 15 to 34 weeks of gestation were studied by means of anatomical, digital and statistical methods. In a...

The variations of vessels arising from the aortic arch are numerous. The purpose of this study is the description of the variations on the branching pattern of arch of aorta, in order to offer useful data to anatomists, radiologists, vascular surgeons, neck and thorax surgeons in Nepalese subjects, and relating it with embryological basis. In this investigation, branching patterns of arch of ao...

PURPOSE To describe a precannulated fenestrated endograft system utilizing externalized guidewires to facilitate aortic arch endovascular repair and to report its use in 2 patients with challenging anatomy. TECHNIQUE For distal arch repair, a fenestration for the left subclavian artery (LSA) is made onsite in a standard thoracic endograft tailored to the patient anatomy; it is precannulated w...

BACKGROUND Supraaortic branches limit extended application of endovascular aortic repair. For this purpose, we applied extensive reconstructions. METHODS Between October 2002 and March 2005, 11 patients (mean age 72.3 years) presented with acute or chronic aortic diseases originating from the aortic arch (arch aneurysms n=8, type B dissections n=3). Treatment was by autologous sequential tran...

BACKGROUND The downward movement of the aortic root during the cardiac cycle may be responsible for producing the circumferential tear observed in aortic dissections. METHODS AND RESULTS Contrast injections were investigated in 40 cardiac patients, and a finite element model of the aortic root, arch, and branches of the arch was built to assess the influence of aortic root displacement and pr...

endovascular devices and techniques will evolve to expand applicability and provide therapy for most aortic diseases, including a growing number of diseases of the arch and the ascending aorta [4]. Complex aortic aneurysms that involve major aortic branch origins include those juxtaposed or involving the renal arteries (juxtarenal, perirenal), the visceral arteries (thoraco-abdominal) and the g...

Total endovascular replacement of the aortic arch is a complex procedure that is often favoured when the pathology anatomy precludes a standard median sternotomy. Here we present the case of endograft repair in a 79 year old male with 6.5 cm arch aneurysm and 5.4 cm descending thoracoabdominal aneurysm. Following bilateral carotid-subclavian bypasses, a long 7 Fr sheath was advanced into the de...

OBJECTIVE To compare three different techniques of distal aortic repair in acute type A (de Bakey type I) aortic dissection and to evaluate their impact on the late morphology of the aortic arch and descending aorta and on the incidence of reoperation. METHODS From 65 patients operated on due to an acute type A aortic dissection between 1989 and 1993, 54 long-term survivors underwent clinical...