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Background The purpose of this systematic review and meta-analysis was to determine the prevalence of the number of sigmoid arteries (SA) and variations in their origins. Methods A thorough systematic search of literature through February 2020 was conducted on major electronic databases to identify eligible studies. Data were extracted and pooled into a meta-analysis using Metafor package in R. The primary outcome was the variations in the SA origin (according to modified Zebrowski classification), and the secondary outcome was the prevalence of the number of SA. Results A total of 22 studies (n = 2653 patients) were included. Type 1 modified Zebrowski (separated origins or common trunk of the SA originating from descending recto-sigmoid trunk (DRST)) was the most common origin type of the SA (pooled prevalence estimate (PPE) = 49.67% (95% CI 32. 67- 66.71)), while type 3 (separated origins or common trunk of 1 or 2 SA originating from DRST or superior rectal artery (SRA) and 1 or 2 SA originating from DRST or SRA) was the least common (PPE = 0.18%; 95% CI 0.00–2.82)). Of the Type 1 variants, the not specified (N.S) variant was by far the most prevalent. The number of SA ranged from one to five, with three being the mode (PPE = 42.3%). Conclusion This is the most comprehensive analysis of arterial vascular anatomy of the sigmoid colon. In light of the highly variable anatomical pattern displayed by the SA, thorough pre-operative knowledge of their anatomy can be crucial in minimizing incidences of iatrogenic injury.

The outcome of transarterial chemoembolization for unresectable hepatocellular carcinoma (HCC) relies on the appropriate identification of tumor supplying arteries. HCC derives 90% of the blood supply from the hepatic arteries. However, depending on the tumor's size and location, the extrahepatic collateral artery (EHC) can develop and predominantly supply the tumor. The supraduodenal artery (SDA) arises from the gastroduodenal artery (GDA). On the other hand, the cystic artery (CA) mostly originates from the right hepatic artery. However, a common trunk of the SDA and CA originating from the GDA and feeding the HCC as an EHC has not been reported. We herein present a 76-year-old man with HCC in segment 6, supplied by an EHC from a common trunk of the SDA and CA originating from the GDA. Selective arteriography confirmed the EHC, which was successfully embolized with drug-eluting beads without complications.

Background: The current study aims to determine the prevalence of variations of the aortic arch using computed tomography angiography (CTA), as well as morphometries and gender correlations. Materials and methods: A retrospective, transverse, observational and descriptive study of 220 CTA was performed. The branching pattern, most cranial vertebral level of the aortic arch, area of the proximal, middle and distal segments of the arch, area of each branch, and the path of atypical arteries were recorded. Results were analysed and stratified by gender. Results: The typical aortic arch branching pattern was present in 77.7% without statistical significance between genders. The most common variant was a two-branch pattern with a common trunk and a left subclavian (13.6%), followed by a typical branching pattern with an added left vertebral artery (7.3%). T3 was the most frequent cranial level (32.3%), followed by T2–T3 (26.8%), and T3–T4 (23.2%). The mean areas of the aortic arch were 685.5 ± 183.9, 476.1 ± 124.1, and 445.0 ± 145.1 mm2 for the proximal, middle and distal segments, with statistical difference between men and women in the middle and distal segments. Three paths of atypical arteries were identified: bifurcated vertebral artery (0.5%), aberrant right subclavian artery (0.5%), and left subclavian ostium obstruction (0.5%). Conclusions: Mexican population has one of the highest prevalence of variations in the aortic arch branching pattern. The high probability of finding these should be taken into consideration when assessing patients. A standardised classification method would contemplate future un-reported findings, without causing confusion by the different numbers assigned by each author.

Surgical treatment of the transverse colon is difficult because of the many variations of blood vessels. We reviewed the patterns of vascular anatomy and the definition of the vessels around the splenic flexure. We searched the PubMed database for studies on the vascular anatomy of the splenic flexure that were published from January 1990 to October 2020. After screening of full texts, 33 studies were selected. The middle colic arteries were reported to arise independently without forming a common trunk in 8.9–33.3% of cases. The left colic artery was absent in 0–7.5% of cases. The accessory middle colic artery was present in 6.7–48.9% of cases and was present in > 80% of cases without a left colic artery. The reported frequency of Riolan’s arch was 7.5–27.8%. The frequency was found to vary widely across studies, partially due to the ambiguous definition of Riolan’s arch. A comprehensive preoperative knowledge of the branching patterns of the middle colic artery and left colic artery and the presence of collateral arteries would be helpful in surgery for colon cancer in the splenic flexure.

Axillary artery branching pattern variations are commonly observed during routine dissections. These variations have great importance due to the wide range of therapeutic and diagnostic procedures carried out in the axillary region. Therefore, neurovascular abnormalities should be well-known before surgeries involving the axillary region in order to prevent complications. This case report presents a common trunk at the third part of the axillary artery which gives rise to the deep brachial artery.

Aim To evaluate the frequency and pattern of variations in the origins of right inferior phrenic artery (RIPA) and left inferior phrenic artery (LIPA) on 256 slice multidetector computed tomography (MDCT). Materials and Methods MDCT abdominal images of 600 patients (male: 344, female: 256; mean age 56.45 ± 12.96 years) who underwent technically successful multiphase computed tomography were assessed for IPA variations with emphasis on their origins and results analyzed. Results Both IPA origins were documented in all patients. Both RIPA and LIPA originated from the common trunk in 128 (21.3%) patients. IPAs with common trunk most commonly originated from the aorta (68, 11.3%). Without common trunk RIPA most commonly originated from the aorta (225, 37.5%) and LIPA from the celiac artery (278, 46.3%). The least frequently detected IPA variations were RIPA originating from the common hepatic artery (1, 0.2%), superior mesenteric artery (1, 0.2%), and common truncus originating from left renal artery (1, 0.2%). Conclusion MDCT demonstrates the IPA origins very well, enabling planning of interventional procedures related to IPA. Without common trunk RIPA most commonly originates from aorta and LIPA from the celiac artery. IPAs with common trunk most commonly originate from aorta.

An anomalous common trunk giving rise to bilateral intercostal arteries at multiple levels is exceedingly rare and its association with spinal filar AVF and low-lying cord has not been reported so far. Here, we report this uncommon anatomical variation in a 60-year-old male who presented with paraplegia and on imaging found to have low-lying spinal cord with filar AVF and venous congestive myelopathy and discuss its embryological basis and associated malformations. Although rare, interventional radiologists should be aware of this entity, as these trunks may be a major source of bleeding in patients with hemoptysis, and also may be involved in vital spinal cord supply.

Accessory renal arteries (ARAs) are common and usually originate from the abdominal aorta and the renal artery. Inferior phrenic arteries (IPAs) can also arise from the abdominal aorta or its branches. In this paper, we present the first case of a common trunk of the right ARA and right IPA arising from the thoracic artery at the level of T10, which was discovered by multidetector-row computed tomography in pretherapeutic evaluation and clearly confirmed by selective angiography. It is important to recognize this anatomical variation when performing cardiovascular and interventional radiological procedures.

BACKGROUND We report a rare case of numbness in the right hand, finally diagnosed as bilateral common carotid artery common trunk with aberrant right subclavian artery combined with right subclavian steal syndrome and explain the cause of these diseases. CASE SUMMARY The patient was a 65-year-old woman. She complained of dizziness, numbness and weakness of the right hand for 6 mo. She was diagnosed with bilateral common carotid artery common trunk with aberrant right subclavian artery combined with right subclavian steal syndrome by ultrasound, enhanced computed tomography, computed tomography angiography and other examinations. Considering the surgical risks, the patient refused the aberrant right subclavian artery stent implantation and was discharged. We hypothesize that these two kinds of deformity and right subclavian steal syndrome may not occur by accident and result from multiple malformations. CONCLUSION Bilateral common carotid artery common trunk with aberrant right subclavian artery combined with right subclavian steal syndrome is rare. This case reminds interventional radiologists of the possibility of these abnormalities before surgery.

Background Endoscopic endonasal surgery has proved to offer a practical route to treat suprasellar lesions, including tumors and vascular pathologies. Understanding the different configurations of the anterior cerebral communicating artery (ACoA) complex (ACoA-C) is crucial to properly navigate the suprachiasmatic space and decrease any vascular injury while approaching this region through an endonasal approach. Methods An endoscopic endonasal transplanum-transtubercular approach was performed on 36 cadaveric heads (72 sides). The variations of the ACoA-C and feasibility of reaching its different components were analyzed. The surgical area exposure of the lamina terminalis was also quantified before and after mobilization of the ACoA-C. Results The typical ACoA-C configuration was found in 41.6% of specimens. The following 2 main variations were identified: accessory anterior cerebral artery segment 2 (5, 13.9%) and common trunk of anterior cerebral artery with absence of ACoA (5, 13.9%). Of 101 recurrent arteries of Heubner, 96 (95.0%) were identified within 4 mm proximal or distal to the ACoA. The mean lamina terminalis exposure area was 33.1 ± 16.7 mm2, which increased to 59.9 ± 11.9 mm2 after elevating the ACoA. Conclusions A considerable amount of variation of the ACoA-C can be found through an endoscopic endonasal transplanum-transtubercular approach. These configurations determine the feasibility of lamina terminalis exposure and the complexity of reaching the ACoA. Assessment of ACoA morphology and its adjacent structures is crucial while approaching the suprachiasmatic through a transnasal corridor.

Superselective intra-arterial chemotherapy (SSIAC) for oral cancer can deliver a higher concentration of anticancer agent into a tumor-feeding artery than intravenous systemic chemotherapy. However, the agent distribution between the lingual artery and facial artery (FA) is not clear in SSIAC for patients with the linguofacial trunk. The agent distribution in the SSIAC method was investigated using computational fluid dynamics (CFD). Ten three-dimensional vessel models were created from CT images of two patients with oral cancer (patients A and B) with the linguofacial trunk. Catheter models were combined with vessel models to mimic intra-arterial infusion, and the agent flow was analyzed. In patient A models, the agent distribution varied depending on the catheter tip position in the linguofacial trunk, while all anticancer agents flowed into the FA only in patient B models. This study revealed that the behavior of the agent in the common trunk is determined by the blood flow field which depends on the topography of the vessels in each patient. Therefore, the catheter tip position should be changed according to the vessel topography to deliver anticancer agents into the tumor-feeding artery. Moreover, CFD can be a useful method to predict the agent flow for each patient before SSIAC.

We present a case of a 3-year-old boy with tetralogy of Fallot having the direct origin of the left external carotid artery from the aorta with a common trunk giving rise to the left internal carotid artery and left subclavian artery, in a right-sided aortic arch. We also highlight the potential implications in management.

The aim of this study was to investigate the morphology of the coronary arteries of the goat’s heart. The study was carried out on 36 hearts of adult females dairy goats, belonging to two breeds, aged 7–12 years, with an average body weight of 37 kg. A distinct view of coronary arteries and their branches was obtained by filling them with dyed synthetic latex (LBS 3060) or Batson’s No. 17. In all studied goats the common trunk of the left coronary artery was divided into the interventricular paraconal branch and the circumflex branch. The branch of the interventricular septum originated in the interventricular paraconal branch. In 25 individuals (69%) the circumflex branch ended with small ramifications on the atrial surface of the heart. In 11 individuals (31%), the vessel extended in the subsinuosal interventricular groove into the subsinuosal interventricular branch. The right coronary artery was less developed than the left coronary artery. In 35 individuals (97%) the right coronary artery ended with small ramifications on the atrial surface of the heart. In one goat (3%) the vessel reached the subsinuosal interventricular groove and extended into the subsinuosal interventricular branch.

Arteries supplying the intermandibular, mental, masseteric, buccal, labial, and nasal regions of the face in selected species belonging to the suborder Tylopoda are described in this study. Analyses were conducted on a total of five species representing the family Camelidae based on 27 heads of cadaveric specimens, which were prepared by arterial injection with acetone-dissolved stained vinyl super chloride or stained latex LBS3060. Vascularization of regions of the face was formed by the facial, sublingual, mental, transverse facial, buccal, and infraorbital arteries. It was confirmed that the linguofacial trunk is absent in Camelidae. In turn, in camels the deep temporal artery descended in the common trunk with the transverse facial artery, while in llamas and alpacas it was a direct branch of the maxillary artery. It was shown that the pattern of facial arteries in Camelidamorpha exhibits specific traits for this clade and differs from the system of these arteries in other artiodactyls. The described specific character in arterial vascularization of the face not only expands the spectrum of morphological characteristics in Camelidae, but it also provides information which may prove useful for clinical purposes in veterinary practice. Anat Rec, 301:2122-2127, 2018. © 2018 Wiley Periodicals, Inc.

A common origin of the celiac trunk and superior mesenteric artery is exceedingly rare, and aneurysms of this common trunk are even rarer. According to our literature search, there are no reported cases of nutcracker syndrome or phenomenon involving this rare aneurysmal anomaly. Repair of such anomalies is standardly via open surgical approach with few reported cases of endovascular repair. We describe a patient with an aneurysm of the celiomesenteric trunk (CMT) resulting in nutcracker phenomenon of the left renal vein. The CMT aneurysm was repaired endovascularly, resulting in decreased surrounding inflammation and improvement of the left renal vein compression.

BACKGROUND Little is known about the anatomy of the jejunal veins (JVs) flowing into the superior mesenteric vein (SMV), and whether they can be safely divided during pancreaticoduodenectomy. METHODS Computed tomography was used to review the jejunal branches off the superior mesenteric artery (SMA) and into the SMV in 123 consecutive patients. The common trunk of the JVs (jejunal venous trunk, JVT) was classified as ventral or dorsal to the SMA. RESULTS The first JVT involved multiple JVs in 108 (87.8%) cases. The first JVT diameter (≥7 or

BACKGROUND Study of variations in the branching pattern of axillary artery is of considerable importance. There may be variations in the origin of branches, additional branches or 2 or more from common trunk or the artery may arise separately. The anomalous branching pattern can be correlated to the developmental defects of vasculature during embryonic life. The axillary artery is a part of axis artery of upper limb. Morphological variations of axillary artery of upper limb is very important for vascular surgeons, cardiologists, anaesthetists, radiologists and orthopaedic surgeons. Present study is aimed at finding out the branching pattern of axillary artery, clinical significance and to correlate its embryological basis. MATERIALS AND METHODS The present study was conducted on 20 formalin fixed cadavers (40 limbs), which were allotted to the undergraduate, postgraduate students and BDS students of Government Medical College, Kottayam. Cadavers were numbered 1-20 and the axillary artery and its branches were dissected on both sides following the classical incision and dissection procedure taking care to preserve all branches. The artery was studied under the following headings- 1. Origin of all branches; 2. Course and variation. RESULTS In the present study, it was observed that the branching pattern of axillary artery showed variations in 80% of cases. 8 upper limbs showed normal pattern of distribution (20%). The branches revealed different levels of origin and distribution from the normal pattern. The most common variations observed in the origin of subscapular artery and anterior and posterior circumflex humeral arteries together constitute 40%. The remaining 40% of variations were observed in superior thoracic (17.5%), thoracoacromial (12.5%) and lateral thoracic (10%). These observations in the arterial variations highlights the awareness during regional surgeries and other interventional procedures. CONCLUSION Variations observed in this study are similar to that of other studies, which have been conducted elsewhere across the globe. A clear knowledge of such variations were very essential for the operating surgeons, cardiologists and interventional radiologists to avoid undesirable complications during the interventional surgical procedures in the upper limb region.

We have encountered in our anatomical practice the first case and an extremely rare second case in which the ascending, transverse, descending, and sigmoid colons were supplied by the inferior mesenteric artery. The causes of colic artery anomalies are generally explained in conjunction with the development of the superior mesenteric artery, which is intimately related to embryonic elongation and midgut rotation. However, this embryological model was inapplicable to both cases. This difficulty motivated us to seek possible relationships with reported anomalous inferior mesenteric arteries in adults as well as their embryological causes. We consider that the aberrant right colic artery found in 2009 is an "intermesenteric artery" which anastomoses the superior (or its middle colic branch) and inferior mesenteric artery, but secondarily lost its origin from the superior mesenteric artery. The aberrant colic artery found in 2010 is a "middle-inferior mesenteric artery" in which the inferior mesenteric artery formed a common trunk with remnant middle mesenteric artery.

The superior thyroidal artery, lingual artery, and the facial artery supply the musculocutaneous tissue, visceral organs including buccal mucosa, oral cavity, oropharynx, hypopharynx and larynx, salivary glands, and thyroid glands at the upper cervical and facial level. These arteries anastomose each other via their branches, and often originate from the common trunk.

The aortic arch may present a plethora of anatomical variations, which my cause a cluster of complications in interventional procedures in surgery and angiography. We present a rare case of a common origin of both the common carotids arteries from the brachiocephalic trunk (anonymous artery), with the left common carotid artery emerging from the initial portion of it, forming a small common trunk. The great importance towards an excellent knowledge of the topographical aortic arch anatomy is stressed out.

A 67-year-old woman with epigastric pain was diagnosed with resectable pancreatic head cancer and underwent pancreatoduodenectomy. Preoperative computed tomography showed that the common hepatic artery formed a common trunk with the left gastric artery running to the liver through the lesser omentum, and no other arterial supply to the liver was identified. Pancreatoduodenectomy was performed uneventfully without injury to any hepatic arteries. The postoperative clinical course was largely uneventful, and the patient was discharged on postoperative day 19. An anatomical variation of the common hepatic artery arising from a common trunk with the left gastric artery and coursing within the lesser omentum is rare. Notably, this is the first case report of pancreatoduodenectomy with this anatomical variation. Thorough understanding of hepatic arterial anatomical variations is necessary to prevent complications caused by inadvertent vascular injury and hepatic ischemia.

Background and aims: Study of origin of obturator artery, its variable origin and course is significant as knowledge attained by such studies help surgeons to avoid injuries, hemorrhage during operative procedures. Present study is aimed at finding out the variable origin of obturator artery, clinical significance and to correlate its embryological basis. Materials and Methods: Present study was conducted on 60 formalin fixed hemi section of cadaveric pelvis, which were allotted to the under graduate students of Mandya Institute of Medical Sciences, Mandya. Observations obtained were compared with the studies of previous workers. Results: Normal pattern of origin, from the anterior division of internal iliac artery was seen in 40% (24 cadavers). In 60% of the cadavers variations were observed. The most common variant mode of origin was from inferior epigastric artery (18.3%). Next common was origin from superior gluteal artery and least common variant of origin was from inferior vesical artery. Conclusion: Variations observed in present study were at par with the variations observed by previous studies. Although anomalous origins of the obturator artery rarely produces clinical symptoms, their knowledge is necessary for operating surgeons to avoid injuries and is of academic interest.

Background and aim: Study of variation in branching pattern of arch of aorta is important for cardio­ vascular surgeons to avoid injury during procedures like angiography and stenting of aorta. These variations are frequently encountered during surgical procedures, as a developmental alteration in branchial arch during embryonic period. The aim of present study is to describe variation in branching pattern of arch of aorta belonging to Gujarati population and these results will be of significance for anatomists for relating it with embryological basis, cardiovascular surgeons and radiologists. Materials and metbods: Forty embalmed cadavers were observed for study of branching pattern of arch of aorta during period of four year in Department of Anatomy in Smt N.H.L.Municipal Medical College, Ahmedabad. Results: In the present study, normal branching pattern of the arch of aorta was found in 92.5% cases. In 2.5% cases only two vessels originated from the arch of aorta, one of them was common trunk for brachiocephalic trunk and left common carotid artery and the second trunk was left subclavian artery. In 5% of cases four vessels arose from arch of aorta, the left vertebral artery arose directly from aorta with normal branching pattern. Conclusion: Vascular invasive procedures are increasing since last decade. So knowledge of variation in branches of arch of aorta is essential for cardiologist, cardiovascnlar surgeon as well as for radiologist.

We describe the heart from a 79-year-old woman with no medical history of cardiac complaints. Her heart shows a regular right coronary artery (RCA) and a variant left coronary artery (LCA) arising from the right sinus of Valsalva. The common stem of the RCA and the LCA is extremely short. The LCA depicts a preinfundibular course with a cranial-anterior loop and reaches the intersection of the anterior interventricular sulcus and the left coronary sulcus, where it divides into the regular branches, the anterior interventricular branch (left anterior descending, LAD) and the circumflex branch (left circumflex, LCx). All further branching resembles a normal distribution with the posterior interventricular branch coming for the RCA. Such a variant LCA is extremely rare with a reported incidence of 0.17 %. However, recognition and angiographic demonstration of such a variation assume the highest priority in a patient undergoing, for instance, direct coronary artery surgery or prosthetic valve replacement.

Background Primary complete repair of truncus arteriosus (TA) is the goal in the current era of cardiac surgery. In the absence of valved conduits, non-conduit repair remains possible in spite of less optimal hemodynamics and could be a solution for this category of patients in the developing countries. Patients and methods This is a review of eight patients operated upon in the national heart institute from January 2013 to November 2015. They underwent non-conduit repair of truncus arteriosus by the modifications of the Barbero-Marcial technique through window like separation of the common trunk, approximating the pulmonary artery to right ventricular outflow tract and completed by autologous pericardial patch. Results The mean age was 43.75 days with range 20–80 days. The mean body weight was 3.5 kg with range 2.8–4.5 kg. There were two early mortality cases in the intensive care unit (ICU). The mean ventilation time was 38.6 h with range 18–66 h. The mean ICU stay was 6.3 days with range 3–11 days. Pre-discharge echocardiography revealed mean gradient across the right ventricular outflow tract (RVOT) 24 mmHg with range 14–34 mmHg and mean grade of pulmonary incompetence (PI) was 2.3 with range of 1–3. Conclusion The non-conduit repair is a good alternative for type I TA, especially when it is the only available solution.

Anatomic variations of the pulmonary artery (PA) cause vascular injuries and result in critical mistakes. Here we report the first case of lung cancer with a fissureless left upper lobectomy, an aberrant mediastinal trunk of the lingular and basal segments of the PA. A 65-year-old man was referred to our hospital with a solid mass on the left upper lobe. A fissureless left upper lobectomy was performed due to severe incomplete lobulation. Intraoperative findings showed an extremely rare anatomic variation (left A5+A8+A9b) that arose as a common trunk from the left main PA. To prevent intraoperative injury, it is essential to consider the unexpected mediastinal inferior branch and perform a surgical procedure such as fissureless lobectomy upon encountering incomplete lobulation.

We report a case of a 79-year-old man presenting with left cervical carotid artery stenosis associated with non-bifurcating cervical carotid artery, a very rare congenital anatomical variation supplying different branches of the external carotid artery directly from a common trunk without a bifurcation. We performed carotid endarterectomy for this symptomatic carotid artery atherosclerotic stenosis. Here, we discuss the treatment strategy, arteriotomy, route for flush out, and usage of a shunt devise system for this characteristic morphology. In addition, the embryological mechanism for developing this rare anatomical variation is discussed.

Purpose : This study was designed to identify the anatomical variations of lumbar arteries on contrast-enhanced multi-detector row computed tomography (MDCT). Materials and Methods : Consecutive 100 colon cancer patients underwent preoperative 3-dimensional navigation studies, which include CT colonography (CTC) and CT angiography (CTA) for evaluation of anatomical relationship between the colon cancer and mesenteric vasculatures. After exclusion of inappropriate cases, 84 cases (33 women and 51 men ; mean age, 64 years) were finally analyzed. The visualization of lumbar arteries from the CTA was scored based on the agreement of two radiology specialists. Also the presence or absence of left and right common trunk of each lumbar artery was evaluated. Results : Visualization scores on both sides of L1 were significantly lower than those of L2-L4. No significant difference could be found on visualization of L1 lumbar arteries between the young and the elderly group. The common trunk tended to be in the lower lumbar levels (L1 in 2.4%, L2 in 9.5%, L3 in 11%, and L4 in 23%). Conclusion : The development and variation of lumbar arteries can be evaluated with CTA. Furthermore, CTA can provide sufficient anatomical information on variations of the lumbar arteries prior to surgery or catheterization.

The aim of this study was to describe the possible anatomical arrangements of the vertebral artery in guinea pig. The study was carried out on 30 adult English self guinea pigs using corrosion technique. After sacrifice, the vascular network was perfused with saline. Batson’ corrosion casting kit no. 17 © was used as a casting medium. After polymerisation of the medium, the maceration was carried out in KOH solution. We found high variability in the origin of vertebral artery. In 10% of the cases, the left vertebral artery originated independently from the left subclavian artery and in 36.7% of the cases originated by means of a common trunk with some another branches. In 50% of the cases, the left vertebral artery was formed by the fusion of two branches originating from a common trunk with some another branches of the left subclavian artery. In 26.7% of the cases, the right vertebral artery originated independently from the right subclavian artery and in 40% of the cases originated by means of a common trunk with some another branches. Right vertebral artery formed by the fusion of two branches originating independently from the right subclavian artery was present in 20% of the cases. In 13.3% of the cases, the right vertebral artery was formed by the fusion of two branches originating from a common trunk with some another branches of the right subclavian artery.

Knowledge of the morphological variations within the abdominal cavity is significant for all medical practitioners planning surgery. This report presents the rare origin of a common trunk for the right inferior phrenic artery, and superior and inferior suprarenal artery from the right renal artery. An accessory hepatic artery was found, which served as a branch of the right inferior phrenic artery. The diameter of the common trunk was 3.95 mm, and the diameters of the inferior and superior suprarenal arteries were 1.84 and 1.36 mm, respectively. The diameter of the right inferior phrenic artery was 2.55 mm. Both the embryological background and the potential clinical significance of this morphological variation are discussed. Knowledge of this common trunk and the occurrence of the accessory right hepatic artery may be of significance in diagnostic and surgical procedures.

Superior Thyroid Artery (STA) usually arises from the ventral surface of the External Carotid Artery (ECA) just below the level of tip of greater cornu of hyoid bone and it runs anteriorly, downwards and medially. Lingual artery arises at the level of tip of greater cornu of hyoid bone and it runs anteriorly, upwards and medially. Rarely, both STA and lingual artery may originate as a common trunk called thyrolingual trunk. But a thyrolingual trunk arising from Common Carotid Artery (CCA) is very rare. We report a case of patient diagnosed to have carcinoma of right lower alveolus with nodal recurrence; with thyrolingual trunk arising from the medial aspect of CCA, which was detected incidentally during neck dissection.

We describe an unusual pattern of branching of a left-sided aortic arch in which the first branch is the right subclavian artery, followed by the common carotid arteries arising from a common trunk. The patient was born with transposition (concordant atrioventricular and discordant ventriculoarterial connections) and had 18q23 deletion. We discuss the implication of these anatomic findings in the light of inferences currently made by echocardiographers when the first branch of the aortic arch fails to bifurcate. We also relate the findings to the concepts of cardiac development and draw comparisons with previous descriptions, and interpretations of the morphogenesis, of the patterns of branching from the aortic arch.

Objectives The frequency of suboccipital injections to treat headaches has increased. The third segment of the vertebral artery is located in the suboccipital triangle and its main muscular branch, the suboccipital artery of Salmon (SAS), supplies blood to the suboccipital muscles. The purpose of this study was to radiographically investigate the morphology and territory of distribution of SAS. Patients and methods Computed tomography angiographs of brains of 50 subjects (25 female, 25 men, mean age 70.2 years) were analyzed. Results SAS was present in 48% of subjects. The vessel was present bilaterally in 37.1%, and had a mean (SD) luminal diameter of 1.71 (0.34) mm and mean (SD) length of 36.42 (17.1) mm. SAS was found to have two morphologic patterns: (1) a single main trunk with collateral branches (52.6%) and (2) a short common trunk that divided into two branches (48.4%). The SAS supplied the obliquus capitis inferior, semispinalis capitis, and splenius capitis muscles. When the SAS was absent, the suboccipital muscles were supplied by a branch of the occipital artery. No anastomoses were found between the SAS and occipital artery. Conclusion The suboccipital muscles are vascularized by the SAS and occipital artery. The detailed course of the SAS is important for clinicians and surgeons who perform procedures in the suboccipital region.

Background Earlier studies have indicated that bovine left common carotid artery configuration occurs in 10.2–22% of patients and increases the complexity of navigating endovascular devices in the aortic arch. However, we anecdotally noted a higher incidence of bovine arch among angiosuite outpatients in Los Angeles, California. Thus, we retrospectively reviewed aortic arch angiograms performed in 93 unique outpatients to determine the true incidence of this anomalous configuration. Methods We were able to obtain complete angiographies from clinical data on 90 patients (mean age 50 years, SD 15.23 years, range 17–88 years) from May 2006 to January 2012. Angiograms were categorized as: normal arch; bovine arch with brachiocephalic trunk; bovine arch with common trunk; or indeterminate. Results The findings indicated an overall 35.16% bovine arch incidence, of which 78.13% is bovine arch with common trunk and 21.88% is bovine arch with brachiocephalic trunk. There was a higher prevalence in the women (40%, n = 60) than men (26.67%, n = 30). Caucasians had a lower incidence of bovine arch (27.78%, n = 47) compared with other ethnicities. The prevalence of bovine arch in different ethnicity and gender groups was assessed and the differences were not statistically significant. Conclusions The incidence of bovine left common carotid artery is higher than previously reported and varies by gender and race. Advanced knowledge of the high prevalence of this anomaly could reduce the risks and increase the efficiency of navigating catheters through the tortuous vessels during endovascular procedures. The clinical implications of this report warrant further investigation.

Background: Axillary artery is known to show different variations mostly in its branching pattern. Similarly, the origin of profunda brachii is often encountered with abnormality. Therefore, when the vascular variations in the upper limb persist, mostly it is confined to its branching pattern followed by its variant origin. But, among all the reported variations of profunda brachii, its variant origin from the 3rd part of the axillary artery with common trunk for the branches of axillary artery is unique. Case Details : We report here an anomalous origin of profunda brachii as continuation of an arterial trunk arising from 3rd part of the axillary artery. This common trunk at its commencement passed between 2 roots of median nerve and gave branches of 3rd part of axillary artery before it continued as profunda brachii artery. The further course and branching pattern of profunda brachii were normal. Conclusion: Since the axillary artery is next choice of artery for arterial canulation in cardiopulmonary bypass procedures, prior knowledge of existence of such variation in its branching pattern helps in avoiding possible diagnostic or interventional therapeutic errors. Keywords: axillary artery, common trunk, profunda brachii, vascular variation

Neste trabalho, sistematizaram-se os ramos colaterais do arco aórtico e suas principais ramifi cações, utilizando 30 coelhos da raça Nova Zelândia. O sistema arterial foi preenchido com látex corado em vermelho através da aorta torácica no sentido contrário ao fl uxo sanguíneo e fi xado em uma solução aquosa de formaldeído a 20%. Os ramos colaterais do arco aórtico foram o tronco braquiocefálico e a artéria subclávia esquerda. O tronco braquiocefálico emitiu as artérias carótidas comuns esquerda e direita, continuando-se como artéria subclávia direita. Esta emitiu, de medial para lateral, as artérias: vertebral, tronco comum cervical superfi cial-profunda e tronco costocervical-torácica interna. Já a artéria subclávia esquerda emitiu as artérias: vertebral, intercostal suprema, torácica interna, escapular dorsal e tronco comum cervical superfi cial-profunda. In this study, the collaterals branches of the aortic arch and its main rami were systematized in 30 New Zealand rabbits (Oryctolagus cuniculus). The arterial system was fi lled with red latex in the opposite direction to blood fl ow, and fi xed in 20% formaldehyde solution. The collaterals branches of the aortic arch were the brachiocephalic trunk and the left subclavian artery. The brachiocephalic truk emitted the left and the right common carotid arteries, continuing as the right subclavian artery. This emitted, from medial to lateral, the arteries: vertebral, superfi cialdeep cervical common trunk and costocervical-internal thoracic trunk. Already the left subclavian artery emitted the arteries: vertebral, supreme intercostal, internal thoracic, dorsal scapular and superfi cial-deep cervical common trunk.

The common carotid arteries are the major source of blood supply to the region of head and neck. Normally external carotid artery gives eight branches in the region of neck. All of them arise independently as separate branches. In the present case, we found lingual and facial arteries arising from a common trunk i.e. linguofacial trunk from the front of external carotid artery on the right side. While on the left side, lingual and facial arteries were arising separately from external carotid artery. Such anatomical variations of external carotid artery are important for surgeons in surgeries of head and neck region and also for radiologists in the image interpretation of the face and neck region.DOI: http://dx.doi.org/10.3126/ijasbt.v1i3.8668 Int J Appl Sci Biotechnol, Vol. 1(3) 2013 : 154-157

The Coeliac trunk and the Superior mesenteric artery are ventral branches of abdominal aorta. Sometimes these two arteries arise from the abdominal aorta in a common trunk. Many literatures are available explaining this type of variation. But this report describes not only the common coeliaco-mesenteric trunk but also a rare variation in their branching. Knowledge about the vascular variations is essential for the clinicians for therapeutic and diagnostic procedures of many abdominal diseases.

During an ordinary dissection, a cadaver showed a bilateral anomalous origin of the deep brachial artery, where this vessel appeared like a branching of the subscapular artery with common trunk, which included the posterior circumflex humeral artery. The course and distribution of the deep brachial artery in the back compartment were relatively consistent with previous reports. Arterial variations can be damaged through iatrogenic means if not properly documented. The knowledge of this case is very important in clinical medicine and in surgeries in this compartment to prevent any injury.

Objective The goal of our study was to analyze the prevalence of branching pattern variations in the popliteal artery (PA) along with morphometrics of the PA to better address its importance in disease and vascular surgical procedures. Methods An extensive search for the PA and its anatomic variations was done in the major online medical databases. The anatomic data found were extracted and pooled for a meta-analysis. Results A total of 33 studies (N = 12,757 lower limbs) were included in the analysis. The most common variant was a division of the PA below the knee into the anterior tibial artery and a common trunk for the posterior tibial and peroneal arteries, with a prevalence of 92.6% (95% confidence interval [CI], 90.2-93.8). The second most common variation was a trifurcation pattern of all three branches dividing within 0.5 cm of each other, with a prevalence of 2.4% (95% CI, 1.4-3.5). Of the three studies that reported the diameter of the PA at the level of the subcondylar plane, a mean diameter of 8 mm (95% CI, 7.29-8.70) was found. Conclusions The PA most commonly divides below the knee into the anterior tibial artery and the common trunk of the posterior tibial artery and the peroneal artery. Knowledge of the prevalence of possible variations in this anatomy as well as morphometric data is crucial in the planning and execution of any surgical intervention in the area of the knee.

Early in the embryogenesis, both primitive proximal external carotid artery (ECA) and internal carotid artery (ICA) arise separately from the third aortic arch: the ECA from its proximal ventral part, and the ICA from the dorsal part. The involution of the third aortic arch involving its segment distal to the origin of the ICA (ductus caroticus) on both left and right sides results in the formation of a common trunk from which develops on each side the common carotid artery (CCA) continuing cranially in the ICA and ECA. In the further evolution, the left CCA is annexed by the developed left fourth aortic arch, and the right CCA becomes a branch of the brachiocephalic trunk (innominate artery) proximal remnant of the distally regressed right fourth aortic arch (Haughton and Rosenbaum 1974).

In a 94-year-old male cadaver, upon which routine dissection was being conducted, a rare variation was found in the gastrophrenic trunk (GPT), the common trunk of the left gastric artery (LGA), right inferior phrenic artery (RIPA), and left inferior phrenic artery (LIPA); the GPT arises from the abdominal aorta. A hepatosplenic trunk accompanied the variation. In this variation, the RIPA first branched from the GPT and then to the LIPA and LGA. Variations in the common trunk of the LIPA and RIPA in the GPT are common, but to our knowledge, a variation (separate inferior phrenic artery in the GPT) similar to our findings has not been previously reported. We discuss the incidence and developmental and clinical significance of this variation with a detailed review of the literature. Knowledge of such a case has important clinical significance for invasive and non-invasive arterial procedures. Therefore, different variations concerning the LGA and inferior phrenic artery should be considered during surgical and non-surgical evaluations.

Las anomalías en el origen y patrón de ramificación de la arteria carótida externa (ACE) son comunes. El nivel de la bifurcación de la arteria carótida común (ACC) y las variaciones en el origen / patrón de ramificación de la arteria carótida externa están bien documentados. En el hallazgo de las arterias occipitales y posteriores surgían de un corto tronco común de la ACE en el lado izquierdo. El conocimiento de las variaciones en el origen y curso de las ramas de la ACE son de suma importancia en la cirugía. Los cirujanos deben ser conscientes de la posibilidad de encontrar estas variaciones, ya que pueden conducir a dificultades en la distinción de las ramas de la arteria carótida externa. Este conocimiento es también importante para los radiólogos en la interpretación de las imágenes de las regiones de la cara y el cuello. Anomalies in the origin and branching pattern of the external carotid artery (ECA) are common. The level of the bifurcation of the common carotid artery (CCA) and the variations in the origin/branching pattern of the external carotid artery are well documented. In the present finding occipital and posterior auricular arteries were arising by a short common trunk from ECA on the left side. Knowledge of variations in the origin and course of branches of ECA is of importance in surgery. Surgeons need to be aware of the possibility of encountering such variations, as they may lead to difficulties in differentiating the branches of external carotid artery. This knowledge is also important for radiologists in the image interpretation of the face and neck regions.

The surgical procedures on the caecum demand a precise knowledge of vascular anatomy of ileocolic region. The aim of this study is to study the arterial supply of the caecum, findings of which may reveal more anatomical facts about the arteries of caecum and their variations. Total 52 specimens of caecum and appendix with their arteries intact were collected, cleaned and dissected. The ileocolic artery and its branches to the caecum, and ileum were traced carefully and observations were recorded. The ileocolic artery arises independently from superior mesenteric artery in 96.88% of cases and ends by dividing into superior and inferior division in 93.76% of cases. The anterior and posterior caecal arteries arise by a common trunk in 56.25%. The ileocolic artery arises from the superior mesenteric artery independently in 96.88% and terminates into superior and inferior division in 93.76% of cases. Common caecal artery seen in 56.25% of cases, arises from inferior division (43.75%), superior division (9.38%) and ileocolic artery (3.12%).Anterior caecal artery arises from superior division (12.5%), inferior division (15.63%), ileocolic artery (3.12%), ileal branch (6.25%) and arterial arcade (6.25%).The posterior caecal artery arises from superior division (18.76%), inferior division (9.38%), ileal branch (3.12%), ileocolic artery (3.12%), arterial arcade (6.25%) and from ascending colic branch of inferior division (3.12%). 21.87% of cases showed additional anterior and posterior caecal arteries.

AIM The azygous anterior cerebral artery (Az) is a rarely observed anomaly of the anterior cerebral artery, and its associated aneurysm is even rarer. Our aim was to evaluate 3-dimensional time-of-flight magnetic resonance angiography (3-D-TOF MRA) in the diagnosis of Az and associated aneurysms. MATERIALS AND METHODS Three thousand five hundred seventy-two consecutive patients underwent 3-D-TOF MRA at 3.0 T. Postprocessing techniques, including volume rendering (VR) and single artery highlighting, were performed by a 3-D specialist. All MRA data and clinical information were recorded and stored in a database for further analysis. RESULTS Fourteen patients (.39%) were identified as having an Az. Among these cases, 3 males (21.43%) had an aneurysm located at the distal bifurcation of the Az, with a mean size of 9.43 ± 3.33 mm. In MRA, the common trunk of the Az was slightly larger in diameter than the A1 segment (2.62 ± .35 mm vs. 2.54 ± .35 mm; P = .008). CONCLUSIONS With the VR technique, 3-D-TOF MRA is feasible and valuable in detecting an Az and associated aneurysm. Our MRA-based study has proved that the Az is a rare anomaly but has a relatively high incidence of associated aneurysms.

A rare case of multiple renal arteries was found in a 78-year-old female cadaver undergoing routine dissection. The characteristic findings in the cadaver included the presence of four right and four left renal arteries with one common trunk (a total of nine renal arteries). This variation may represent an immature form of complicated development of the renal arteries.

Morphogenesis of outflow tract malformations is linked to abnormal rotation and septation of the primitive outflow tract. It leads to the impaired formation of aorta and pulmonary trunk, as well as abnormal relationships of the great arteries. The review presents current opinions on outflow tract development and its most common malformations: common arterial trunk, various forms of ventriculo-arterial discordance and double outlet right ventricle. Formation of the common arterial trunk is related to abnormal formation of the aorto-pulmonary septum. Due to its morphological diversity, numerous classifications were introduced. The authors discuss morphology of the common trunk valve, anatomy of coronary arteries and associated anomalies. Transposition of the great arteries is considered a lateralization and outflow tract rotation defect. Section concerning this one of the most prevalent cardiac malformations presents segmental morphology of the affected heart, relations of the great arteries, associated anomalies, as well as clinical and surgical problems resulting from altered cardiac morphology. Double outlet right ventricle is presented with emphasis on terminological inconsistence and anatomy of various morphological subtypes.

To retrospectively evaluate the depiction of bronchial and non-bronchial systemic arteries with 64-detector row CT in patients undergoing endovascular treatment for life-threatening haemoptysis.64-detector row helical CT and conventional angiography of the thorax were performed in 28 patients (25 males, 3 females; age range, 18-65 years; mean age, 40 years) with life-threatening haemoptysis. CT images were analysed to identify abnormal bronchial and non-bronchial systemic arteries and also to localise them in two planes.Using multidetector CT (MDCT), 43 bronchial arteries were identified on the right side and 46 on the left side. 89% of the right bronchial arteries originated from the right intercostobronchial arteries. A common trunk of origin of the right and left bronchial artery was noted in 46% of cases. 23 non-bronchial systemic arteries were noted on the right side and 41 on the left side. Pleural thickening3 mm was confirmed to be a good predictor of non-bronchial systemic supply. An internal mammary artery diameter of3 mm and an inferior phrenic artery diameter of2 mm were sensitive indicators for non-bronchial systemic supply.MDCT is a good investigation tool for evaluating life-threatening haemoptysis as it confirms the disease process, identifies the origin and ostial position of bronchial arteries, detects non-bronchial systemic arteries and acts as a roadmap for percutaneous transcatheter embolisation.