Clinical discussion of the arteria lusoria: a case report / Discussão clínica a respeito da artéria lusória: um relato de caso

Abstract The right subclavian artery may originate from the left portion of the aortic arch. This aberrant vessel is known as the arteria lusoria. Its course to its usual site runs behind the esophagus, which may cause a disease known as dysphagia lusoria, responsible for symptoms of discomfort. This artery is often associated with other anomalies, such as the non-recurrent laryngeal nerve and the bicarotid trunk, and with diseases such as aneurysms, congenital heart defects, and even genetic syndromes. During routine dissection of a male cadaver fixed in 10% formalin solution, an arteria lusoria was found. This article reports the variation and discusses its embryological, clinical and surgical aspects.

Resumo Em alguns casos, a artéria subclávia direita pode se originar da porção esquerda do arco aórtico. Esse vaso aberrante é conhecido como artéria lusória. Para chegar em sua região, essa artéria passa posteriormente ao esôfago, e pode ser, portanto, causa de uma doença conhecida como disfagia lusória, desencadeando sintomas desconfortantes. A artéria lusória está frequentemente associada com outras anomalias, como o nervo laríngeo não recorrente e o tronco bicarotídeo, assim como pode estar em associação com aneurismas, defeitos cardíacos congênitos e até síndromes genéticas. Durante dissecação cadavérica de rotina, foi observada a presença dessa artéria em um cadáver do sexo masculino fixado em uma solução de formalina a 10%. O objetivo deste trabalho é relatar a variação conhecida como artéria lusória e trazer destaque para seus aspectos embriológicos, clínicos e cirúrgicos.

Ramos colaterais do arco aórtico e suas principais ramificações no cachorro-do-mato (Cerdocyon thous) / Collateral branches of the aortic arch and its main rami in crab-eating fox (Cerdocyon thous)

O cachorro-do-mato (Cerdocyon thous) pertence à família Canidae, encontra-se amplamente distribuído pela América do Sul. Devido à escassez literária a respeito da morfologia desta espécie objetivamos colaborar com o conhecimento da anatomia do arco aórtico e seus ramos colaterais. Foram estudados quatro animais, sendo 2 machos e 2 fêmeas oriundos da Mina de Bauxita, Paragominas, Pará, Brasil/Terra Ltda, sob autorização da SEMA-PA nº 455/2009, que morreram por causas naturais. O sistema arterial foi preenchido com látex corado em vermelho e fixado em solução aquosa de formoldeído 10%. O arco aórtico de Cerdocyon thous apresentou em sua origem apenas dois vasos, o tronco braquiocefálico e a artéria subclávia esquerda. Do tronco braquiocefálico originou-se o tronco bicarotídeo, que se bifurcou nas artérias carótidas comum direita e esquerda, e artéria subclávia direita. Das artérias subclávias ocorreu a formação do tronco costocervical, artéria vertebral, artéria torácica interna, artéria cervical superficial e ao atingir o espaço axilar passa a ser chamada de artéria axilar em ambos os antímeros. Concluímos que o arco aórtico de Cerdocyon thous é similar ao de outros animais domésticos com relação ao número de ramificações em sua origem.(AU)

Crab-eating fox (Cerdocyon thous) belongs to the Canidae family distributed in South America. Due to literary scarcity regarding the morphology of this species, we objectifiked to collaborate with description of the anatomy of the aortic arch and its collateral branches. We studied four foxes, 2 males and 2 females, from Mina Bauxita, Paragominas, Pará, Brazil/Terra Ltda, under authorization of SEMA-PA nº 455/2009, that died of natural causes. The arterial system was filled with red latex and fixation with 10% formaldehyde solution. The aortic arch of Cerdocyon thous showed that in its origin are two vessels, brachiocephalic trunk and left subclavian artery. From brachiocephalic trunk originates the bicarotid trunk, bifurcated into left and right carotid common arteries, and right subclavian artery. The subclavian arteries originates the costocervical trunk, vertebral artery, internal thoracic artery, superficial cervical artery, to reach the axillary space, and passes to be called axillary artery on both sides. We conclude that the aortic arch of Cerdocyon thous is similar to the one in other domestic animals regarding the number of ramificastions at its origin.(AU)

The arteries root from the aortic arch in the sparrowhawk (Accipiter nisus, Falconiformes: Accipitridae) / La raíz de las arterias desde el arco aórtico en el gavilán (Accipiter nisus, Falconiformes: Accipitridae)

This study was aimed at determining the morphology of the aortic arch in the sparrowhawk. For this purpose, arteries near the heart of six sparrowhawks were assessed. Latex injection method was applied to the three materials and barium sulphate solution was injected into the aorta for angiography in three other materials. It was observed that two major arteries arose from aortic arch in the sparrowhawk: the left brachiocephalic trunk and the right brachiocephalic trunk. These trunks were contiguous arteries but separately originated from the aorta. The brachiocephalic trunks were divided into the common carotid and subclavian arteries after their origins. First, the common carotid arteries are given off by the brachiocephalic trunks. The common carotid artery was giving off esophagotracheobronchial artery and vertebral trunk. Vertebral trunk was locating under the brachial plexus. The subclavian artery was continuations of the brachiocephalic trunk and it was bifurcating to the axillar artery and the pectoral trunk just from its own beginning. The axillary artery passed the brachial plexus crosswise from above, and reached to the wing. The sternoclavicular artery stemmed from ventral aspect of the begining of the axillary artery. The thickest branch of the subclavian artery was the pectoral trunk, which was branched the cranial external thoracic artery, the caudal external thoracic artery, the dorsal thoracic artery, and the internal thoracic artery. It is hoped that the results of this morphological study will contribute to the species specific anatomical data in the birds.

El objetivo fue determinar la morfología del arco aórtico en el gavilán. Para este fin, se evaluaron las arterias próximas al corazón de seis gavilanes. En tres aves se inyectó una solución de látex, mientras que en las tres restantes se inyectó a través de la aorta sulfato de bario para someterlas luego a un estudio por angiografía. Se observó el origen de dos arterias principales del arco aórtico del gavilán: el tronco braquiocefálico izquierdo y el tronco braquiocefálico derecho. Estos troncos se presentaron como arterias contiguas, pero que se originaron por separado de la aorta. Los troncos supraaórticos se dividieron después de su origen en las arterias carótida común y subclavia. Las arterias carótidas comunes se emiten a partir de los troncos supraaórticos. La arteria carótida común emitió una arteria esófago-traqueobronquial y el tronco vertebral. El tronco vertebral se localizó por debajo del plexo braquial. La arteria subclavia se continuó a partir del tronco braquiocefálico y se bifurcó en arteria axilar y tronco de las arterias pectorales justo desde su propio inicio. La arteria axilar cruzó el plexo braquial transversalmente desde arriba, y llegó al ala. La arteria esternoclavicular derivó de la cara ventral del inicio de la arteria axilar. La rama más gruesa de la arteria subclavia fue el tronco de las arterias pectorales, que se ramificó en arteria torácica externa craneal, arteria torácica externa caudal, arteria torácica dorsal, y la arteria torácica interna. Se espera que los resultados de este estudio morfológico sean una contribución para aportar datos anatómicos específicos en esta especie de aves.

Branching pattern of aortic arch in the white-eared opossum (Didelphis albiventris) / Ramescência do arco aortico no gambá-de-orelha-branca (Didelphis albiventris)

Knowledge of the aortic arch main and collateral branches is important because these arteries supply vital organs found in the head, neck, thoracic cavity and forelimbs of domestic and wild animals. This study aimed to contribute to the anatomical knowledge in opossums and collaborate with veterinary medical and surgical clinics. Thus, the anatomy of aortic arch was described in eighteen opossums. The results indicated that the aortic arch gives off the brachiocephalic trunk and the left subclavian artery in all animals studied. The branching pattern of the aortic arch is similar to that reported in the guinea pig, chinchilla, paca, raccoon, nutria, red squirrel, and ocelot. The brachiocephalic trunk showed as collateral branches, the right subclavian artery and the bicarotid trunk, that originated in the right and left common carotid arteries (77.7%). Bicarotid trunk was absent in four animals (22.2%). The right and left subclavian arteries originated in the vertebral artery, costocervical trunk, internal thoracic artery, and superficial cervical artery. Collateral branches of the subclavian artery showed similarities to that observed in other wild animals such as paca, ocelot and rock cavy.(AU)

O conhecimento do comportamento das artérias que emergem do arco aórtico é importante, pois estas artérias irrigam órgãos vitais encontrados na cabeça, pescoço, cavidade torácica e membros torácicos de animais domésticos e selvagens. Com o objetivo de contribuir com o conhecimento anatômico em gambás e colaborar com a clínica médica e cirúrgica de animais selvagens, descreveu-se neste estudo, a ramescência do arco aórtico em dezoito gambás. Os resultados indicaram que o tronco braquiocefálico e a artéria subclávia esquerda se originaram do arco aórtico em todos os animais estudados. Este padrão de ramescência do arco aórtico é similar ao descrito para a cobaia, chinchila, paca, mão-pelada, nutria, esquilo-vermelho e jaguatirica. O tronco braquiocefálico apresentou como ramos colaterais, a artéria subclávia direita e o tronco bicarotídeo, o qual se bifurcou nas artérias carótidas comuns direita e esquerda (77,7%). O tronco bicarotídeo não apareceu em quatro animais (22,2%). As artérias subclávias direita e esquerda originaram a artéria vertebral, o tronco costocervical e, as artérias torácica interna e cervical superficial. A ramescência encontrada nas artérias subclávias do gambá mostrou similaridades quando comparada com a descrita para outros animais selvagens como a paca, jaguatirica e o mocó.(AU)

Ramos colaterais do Arco aórtico do preá (Galea spixii Wagler, 1831) / Collateral branches of the aortic arch of galea (Galea spixii Wagler, 1831)

O preá é um roedor típico da caatinga pertencente à família Caviidae. Considerando a inexistência de dados sobre o arco aórtico do preá, foi realizado este estudo tendo como objetivo descrever os ramos colaterais do arco aórtico neste cavídeo, e dessa forma, contribuir com dados para biologia da espécie. Foram utilizados vinte preás machos provenientes de estudos anteriores e encontravam-se armazenados em freezer no Centro de Multiplicação de Animais Silvestres (CEMAS/UFERSA). Os animais foram descongelados, a cavidade torácica foi aberta, a aorta canulada e o sistema vascular lavado com solução salina e em seguida, injetado látex Neoprene corado com pigmento vermelho, amarelo ou branco. Posteriormente, os animais foram fixados em formol e depois de 72 horas, dissecados e analisados, sendo obtidos desenhos esquemáticos e os exemplares mais representativos fotografados. O arco aórtico do preá emitiu como ramos colaterais, o tronco braquiocefálico e a artéria subclávia esquerda. O tronco braquiocefálico originou na maioria das peças estudadas, a artéria carótida comum esquerda e o tronco braquiocarotídeo, do qual surgem as artérias subclávia direita e carótida comum direita. As artérias subclávias direita e esquerda em todos os animais estudados emitiram a artéria vertebral, a artéria torácica interna, a artéria cervical superficial, o tronco costocervical e a artéria axilar. O padrão da formação do arco aórtico do preá assemelhou-se ao observado em outros roedores, tais como no mocó, no porquinho-da-índia e na chinchila...

Galea spixii is a typical rodent of the caatinga belonging to the Caviidae family. Considering the lack of data on the aortic arch of the galea, this study aimed to describe the collateral branches of the aortic arch in this specie and to contributes to knowledge of its biology. Twenty males from previous studies were used which had been stored in a freezer at Multiplication Center of Wild Animals (CEMAS/UFERSA). The animals were thawed, the thoracic cavity was opened and the aorta cannulated vasculature was washed with saline and then injected with Neoprene latex colored with red pigment, yellow or white. Subsequently, the animals were fixed in formalin and after 72 hours dissected and analyzed, to obtain schematic drawings and the most representative samples were photographed. The cavy aortic arch issued as collateral branches, the brachiocephalic trunk and the left subclavian artery. The brachiocephalic trunk afforded in most of the specimens the left common carotid artery and the brachiocarotid trunk, where the right subclavian and right common carotid arteries arise. The right and left subclavian arteries in all animals studied issued the vertebral artery, internal thoracic artery, superficial cervical artery costocervical trunk and axillary artery. The pattern of formation of the aortic arch of galea was similar to that observed in other rodents, such as the kerodon, the guinea pig and chinchilla....

Variante de Arco Aórtico en Cadáver Humano / Aortic Arch Variant in Human Cadaver

Se muestra una variante anatómica de arco aórtico proyectado posteriormente hacia la derecha de la tráquea y del esófago que genera en sentido proximal-caudal una arteria carótida común izquierda, una arteria carótida común derecha, una arteria subclavia derecha y finalmente una arteria subclavia izquierda derivada posteriormente de la parte descendente de la aorta. Se muestra igualmente como consecuencia de la variante morfológica disminución del volumen aéreo circulante hacia y desde los bronquios debido a compresión traqueal con reducción de su diámetro.

It shows an anatomy variant of the aortic arch projecting to the right of the trachea and esophagus that generated in-flow proximal left common carotid artery, right common carotid artery, right subclavian artery and finally a left subclavian artery subsequently derived from the descending aorta. It also shows involvement of circulating air volume decreased to and from the tracheal bronchus due to compression to reduce its diameter.

Caracterizacion de las ramas del arco aórtico en una muestra de poblacion colombiana: un estudio con material de autopsia / Characterization of aortic arch branches in a colombian population sample. A study with autopsy material

La variabilidad del arco aórtico y sus ramas emergentes presentan implicaciones en los abordajes quirúrgicos de tórax y cuello, y posiblemente en el desarrollo de procesos ateromatosos ubicados a ese nivel y accidentes cerebrovasculares. Se evaluaron 122 arcos aórticos de individuos adultos de ambos sexos obtenidos como material de autopsia. Se identificó la configuración general de la emergencia de las ramas colaterales de los arcos y se determinó la morfometría de sus componentes con medición electrónica. Se observó la presencia de la configuración usual (tipo A) en 87 arcos (71,3 por ciento); un tronco braqui-bicarotideo (tipo B) en 21 piezas anatómicas (17,2 por ciento) y en 10 casos (8,2 por ciento) la arteria vertebral izquierda se originó directamente del arco aórtico (tipo C); en 4 especímenes (3,3 por ciento) se presentó emergencia atípica de las ramas. El calibre de la aorta en el punto previo a la emergencia de sus ramas y justo después de emitir su última colateral fue de 20,1mm (DE 3,19) y 17,2mm (DE 2,57) respectivamente, con una disminución del 14,5 por ciento. El calibre de las arterias sublavias (7,7mm, DE 1,10) fue significativamente mayor (P=0,0001) que el de las arterias carótidas (6,4mm, DE 0,78). El diámetro de las arterias carótidas derecha e izquierda fue de 6,5mm (DE 0,81) y 6,3mm (DE 0,75) respectivamente. La arteria subclavia derecha presentó mayor calibre que la izquierda (7,9mm, DE 1,09; 7,6mm, DE 1,12) sin diferencia estadisticamente significativa (P=0,0801). La distancia entre el origen del tronco braquiocefálico y el de la subclavia izquierda fue de 32,8mm (DE 6,16) y la longitud del tronco braquiocefálico fue 30,2mm+/-5,27. Se destaca la alta frecuencia de arcos con emergencia de dos y cuatro ramas. Los calibres de las ramas son menores a lo reportado en la literatura.

The variability of the aortic arch and its emergent branches have implications in the surgical approaches of the thorax and neck, and possibly in the development of the atheromatous processes located at that level and the cerebrovascular accidents. We evaluated 122 aortic arches from adult individuals of both sexes obtained as autopsy material. We identified the general configuration of the emergence of the collateral branches of the arcs and determined the morphometry of its components with electronic measurement. We observed the usual configuration (type A) in 87 arches (71.3 percent); a brachio-bicarotid trunk (type B) in 21 anatomical specimens (17.2 percent) and in 10 cases (8.2 percent) the left vertebral artery originated directly from the aortic arch (type C); 4 specimens (3.3 percent) presented atypical emergency in the branches. The caliber of the aorta at the point prior to the emergence of its branches and just after casting his last side was 20.1mm (DS 3.19) and 17.2mm (DS 2.57) respectively, with a decrease of 14.5 percent. The caliber of the subclavian arteries (7.7mm, SD 1.1) was significantly higher (P=0.0001) than of the carotid arteries (64mm, SD 0.78). The diameter of the carotid arteries both right and left were 6.5mm (DS 0.81) and 6.3mm (DS 0.75) respectively. The right subclavian artery presented higher caliber than the left (7.9mm, DS 1.09; 7.6mm, DS 1.12) without significant statistical difference (P=0.0801). The difference between the origin of the brachiocephalic trunk and the left subclavian artery was 32.8 (DS 6.16); the brachiocephalic trunk length was 30.2mm +/- 5.27. It highlights the high frequency of arches with emergency of two and four branches. The calibers of the branches are smaller than those reported in the literature.

Variation of the origin of aortic arch branches: in relationship with plates of atheroma / Variación del origen de las ramas del arco aórtico: relación con placas de ateromas

The aortic arch branches variations have called the attention of several authors, who have handled studies and classifications, both human and in different animals. The common trunk, which is between the brachiocephalic trunk and the common left carotid artery, is the most common variation. We conducted a descriptive and randomized study of the presence of the trunk mentioned before, trying to establish the possible relationship between this variation and the distribution plates of atheroma. The lumen observation makes it possible to define and check the distribution of the ostium, among the common ostium and the ones with common trunks. Regarding the plates of atheroma, it was found that there is a slight prevalence in common trunks cases, with respect to the classics (no variety) or the ones who had common ostium. In all cases, the presence of a plaque in the distal aortic arch was certified near the left subclavian artery. The knowledge of the existence of the common trunk sets up an act of academic interest, as practice interventions and diagnostic imaging and clinical work, since the presence of the common trunk might be related to the prevalence of the plates of atheroma at the level of its origin.

Las variaciones de las ramas del arco aórtico han llamado la atención de diversos autores, quienes han realizados estudios y clasificaciones, tanto en humanos, como en diferentes animales. El tronco común, entre el tronco braquiocefálico y la arteria carótida común izquierda, es la variación más frecuente. Realizamos un estudio descriptivo y randomizado de la presencia del mencionado tronco, tratando de verificar la posible relación entre dicha variación y la distribución de placas de ateroma. La observación luminal permitió precisar, entre los casos de ostios comunes y aquellos con troncos comunes, y comprobar la distribución de los ostios. En cuanto a las placas de ateroma, se observó una leve prevalencia en los casos de troncos comunes respecto de los clásicos (sin variedad) o de los que presentaron ostios comunes. En todos los casos se verificó la presencia de una placa en el arco aórtico distal, inmediato a la arteria subclavia izquierda. El conocimiento de la existencia del tronco común, constituye un hecho de interés académico, como práctico en intervencionismo, diagnóstico por imagen y la clínica. La presencia del tronco común pareciera estar relacionada con cierta prevalencia de placas de ateroma a nivel de su origen.

Ramas emergentes del arco aórtico en fetos humanos: un estudio descriptivo directo en población colombiana / Branches arise of the aortic arch in human fetus: a descriptive direct study in Colombian population

Las variaciones anatómicas en el número y ubicación de ramas emergentes del arco aórtico tienen diversos grados de implicación clínica y de su identificación oportuna depende el manejo y pronóstico de las alteraciones asociadas. Al revisar su compleja morfogénesis y reportes bibliográficos previos surge la hipótesis de si algunas formas de expresión pudieran ser transicionales durante la gestación y no manifestarse en el adulto. En Colombia no hay registros directos sobre la expresión morfológica de las ramas del arco aórtico en población fetal, razón que motiva el desarrollo del presente trabajo. Se analizaron 51 bloques cardiopulmonares de fetos mortinatos sin anomalías cardiovasculares, entre 17 y 40 semanas de gestación, cuyos lechos vasculares fueron repletados con resina poliéster. Luego se valoró el número de ramas emergentes del arco aórtico y la distancia entre ellas de acuerdo a la edad gestacional. La forma usual de presentación con 3 ramas en el arco aórtico se encontró en 56.9 por ciento de los casos, en el 27,5 por ciento se originaron 2 ramas, y en el 15,7 por ciento 4 ramas. La distribución del número de ramas por edad gestacional no mostró diferencia significativa (p>0,1). La distancia entre la primera y última ramas aumentó linealmente con la edad gestacional, pero no se observó diferencia significativa (p>0,1) entre el número de ramas y las semanas de desarrollo de los fetos evaluados. Nuestra frecuencia de variaciones en el número de ramas del arco aórtico es superior a la reportada en la literatura, particularmente en los arcos con 4 ramas en la totalidad de los cuales el vaso adicional se ubica entre la carótida común y la subclavia izquierdas. Nuestros resultados sugieren que estos patrones morfológicos están definidos desde el período embrionario y no se modifican en el transcurso de la gestación.

The anatomic variations in position and number of branches arise of the aortic arch have different grades of clinical implication and the right treatment and prognosis of associated anomalies depend of their early diagnosis. Reviewing your morphogenesis complex and previous literature come up the hypothesis about some expression could be transitional during gestation and do not to express in postnatal life. The morphological expression of the branches of the aortic arch in human fetuses is unknown in Colombia and that is why this study has been developed. 51 cardiopulmonary blocks obtained from stillborn fetus from 17th to 40th gestation weeks without cardiovascular anomalies, were analyzed and filled with polyester resin. Then the number of branches arises from the aortic arch and the distance between them was also analyzed through gestation. In 56.9 percent of the cases 3 branches are arisen from the aortic arch, 2 branches in 27.5 percent and 4 branches in 15.7 percent. The number of branches according to gestational age showed no significant difference (p>0.1). Distance between the first and the last branches increases linearly with gestational age, but showed no significant difference (p>0.1) between the number of branches and the gestation's weeks of the analyzed fetus. The variations found in the number of branches from the aortic arch are further than what literature reports, especially in cases with 4 branches, in these cases the additional branch was between left common carotid and left subclavian artery. These findings indicate than the morphologic patterns were defined since the embryonic stage, and they do not change during gestation.

[ Rare Variation of Right Subclavian Artery Origin from Posterior Surface of Aortic Arch]

Several variations of aortic arch have been reported yet. In present study another variation of aoictic arch was reported. Right subclavian artery arises from posterior surface of the distal end of the aortic arch we present a variation of an aorticarch in which right subclavian artery arises from posterior surface of the distal end of the aortic arch and passing behind esophagus to reach right side of neck. Conclusion: Review of literature showed that regarding origin of the artery this variation was reported for tile first time by the authors It seems that the artery narrowed the position the esophagus However there were not any other sign of side effect on anatomical structure and of their blood supply

Stent carotídeo: estado del arte / Carotid stenting: state of the art

El implante percutáneo del stent carotídeo es utilizado ampliamente en todo el mundo como una alternativa menos invasiva a la endarterectomía carotídea para la prevención del ataque cerebrovascular isquémico causada por una estemosis arterial carotídea extracraneana. La estenosis arterial carotídea que particularmente involucra el origen de la arteria carótidea interna, es un problema clínico frecuente. Esta estenosis de etiología invariablemente aterosclerótica, puede presentarse como un soplo carotídeo asintomático descubierto en el examen físico, o por ataques isquémicos transitorios relacionados con la embolización de trombos originados en el sitio de lesión, o menos comúnmente como un ataque isquémico cerebral. Recientes estudios observacionales y aleatorizados han demostrado que el riesgo de sufrir un accidente cerebrovascular o muerte relacionado con el implante de stent carotídeo es comparable a endarterectomía carotídea, cuando operadores entrenados realizan estas intervenciones en grupos de pacientes bien definidos.

Carotid artery stenting is now utilized worlwide as a less invasive alternative to carotid end arterectomy for the prevention of ischemic strokes caused by stenoses at the extracraneal bifurcation of carotid arteries. Carotid artery stenosis, particularly involving the origin of the internal carotid artery, is a frequently encountered clinical problem. Such stenoses, almost invariably atherosclerotic, can present as an asymptomatic bruit discovered on physical examination, asone or more transient ischemic attacks related to embolization from a stenotic lesion or less commonly, as an ischemic stroke. Recent observational and randomized studies have shown that the risk of procedure-related stroke and death is comparable with carotid endarterectomy when skilled operators perform these interventions in well-defined patient subsets.

Variations in branching pattern, shape, size and relative distances of arteries arising from arch of aorta.

Hundred aortic arches were studied in adult cadavers (aged 40-70 years) for variations in the origin of branches at arch of aorta in situ and for observing the lumenal diameters and relative distances between the adjacent branches. Usually described three branches arising at arch of aorta were observed in 77.0% specimens. Two branches arising from arch of aorta, having different branching pattern were observed in 12.0%:--(i) BC trunk; left brachiocephalic which divided into right common carotid and right subclavian (ii) common origin of BC and LCC; LSC. (iii) common origin of BC and LCC; common origin of LSC and left vertebral. While, four branches were observed in 11.0% showing separate openings:--(i) BC; LCC; LV; LSC (ii) BC; thyroid ima; LCC; LSC (iii) BC, mediastinal; LCC; LSC. At the lumenal surface of the arch of aorta the lumenal openings showed a similar pattern corresponding to the arterial branches on the external surface. These openings were oval in shape in 90.0% with the mean maximum anteroposterior diameters being greater than the mean maximum side-to-side diameters (p < 0.001), while they were elliptical in 10.0%. The BC artery showed largest size followed by LSC and then LCC in most of the branching patterns (p< 0.001). The mean transverse distances between adjacent lumenal openings of these branches were significantly greater than the mean vertical distances (p < 0.001). Approximation of LCC to BC trunk was seen in 10.0% specimens. These observations may be important while invading the arch of aorta and its branches by instruments, as all areas are now susceptible to surgical attack.

Colaterais do arco aórtico no Gambá (Didelphis albiventris) / Collaterals of the aortic arch in opossun (Didelphis albiventris)

No presente trabalho, foram utilizados 28 espécimes de Didelphis albiventris, 10 fêmeas e 18 machos. Após o preenchimento do sistema arterial com neoprene-látex corado, procedeu-se à dissecçäo para observaçäo da disposiçäo dos colaterais do arco aórtico. Em 11 casos (39,29 por cento), originou-se do tronco braquiocefálico primeiramente a artéria subclávia direita e posteriormente o tronco bicarotídeo o qual fornece as artérias carótidas comuns direita e esquerda. Em sete preparaçöes (25 por cento), o tronco braquiocefálico trifurcou-se, originando as artérias subclávia direita, carótida comum direita e carótida comum esquerda. Em cinco observaçöes (17,86 por cento), originou-se do tronco braquiocefálico primeiramente a artéria carótida comum esquerda e, logo após, a artéria subclávia direita e a artéria carótida comum direita. Em quatro achados (14,28 por cento), näo houve a formaçäo de um tronco braquiocefálico, primeiramente originou-se a artéria subclávia direita e, a seguir, um tronco bicarotídeo. Em um caso (3,57 por cento), originou-se do tronco braquiocefálico a artéria subclávia direita e a artéria carótida comum direita, sendo a origem da artéria carótida comum esquerda diretamente da aorta. Em todos os casos observados, a artéria subclávia esquerda originou-se diretamente da artéria aorta.

Gross anatomical study of the aortic ARC branches of the paca (Agouti paca, Linnaeus, 1766)

It was described the distribution of the aortic arc in eight animals of the Agouti paca species, which were 2 adult females, 3 young males and 3 young females that came from the Wild Animal Sector at the Faculty of Agrarian and Veterinary Sciences of Jaboticabal - UNESP. After natural death, the animals had their arterial vessels injected with Neoprene latex 650® coloured by a specific pigment and set in a 10 percent formalin solution. After dissection, it was noticed that the aortic arc gives off the left subclavian artery and the brachiocephalic trunk. The latter originates the left carotid common artery and other trunk, that gives off the right carotid common artery and the right subclavian artery, that originates the vertebral artery, the costocervical trunk, the superficial cervical artery, the axillary artery and the internal thoracic artery, as well as it happens in the left subclavian artery. In just one animal, the left common carotid artery takes a siphon-shaped path just after its origin in the right subclavian artery. In other animals, the left common carotid artery occurs as a straight path

Características estructurales de la aorta de conejo oryctolagus cuniculus / Structural features of the aorta of rabbit oryctolagus cuniculus

La estructura microscópica de la aorta de conejo fue estudiada, con recursos de microscopías óptica, electrónica de barrido y de transmisión, en las porciones ascendente torácica y abdominal, observándose variaciones morfométricas en el diámetro vascular y espesor de las capas de la pared aórtica. Los valores obtenidos fueron, generalmente, mayores en la porción ascendente. Características estructurales de la pared vascular fueron descritas, destacándose la presencia de pliegues en la túnica íntima; la formación de conexiones mioelásticas en la túnica media, variaba el número de lamelas elásticas en distintos segmentos, siendo mayor en las porciones torácicas ascendente y descendente, en relación a la porción abdominal. En la túnica adventicia predominaban las fibras del conjuntivo, dispuestas de forma variada, constituyendo una red. Los resultados fueron discutidos en términos morfofuncionales, teniendo presentes las pequeñas, pero significativas, variaciones segmentares observadas en la estructura de la pared aórtica de conejo

Utilizaçäo de endoprótese auto expansível (stent) posicionada na aorta torácia do cäo / Utilization of auto-expandable stents in diseases of the thoracic aorta of the dog

Este trabalho tem como objetivo a análise histológica de segmentos de aorta de caes submetidos ao implante de endopróteses ("stents" recobertos com Dacron). Para este fim, abordamos a aorta abdominal infra-renal por laparotomia paramediana esquerda. Após a heparinizaçäo, introduzimos neste segmento de aorta o cateter contendo o "stent" até a aorta torácica, onde procedemos à sua expansäo. Todos os caes spbreviveram e foram sacrificados com 30, 60, 90 e 180 dias. A análise histológica demonstrou a perfeita integraçäo da prótese com a parede da aorta e formaçäo de uma neoíntima recobrindo a gaiola metálica. Acreditamos que a utilizaçäo dos "stents" deva contribuir para melhorar os resultados da correçäo cirúrgica das doenças da aorta.

Avaliacao dos diametros normais da aorta toracica e abdominal pela tomografia computadorizada / Evaluation of normalthoracic and abdominal aortic diameters through computorized tomography

Medimos o diametro antero-posterior da aorta toracica ascendente e descendente e da aorta abdominal, de 350 pacientes, sem doencas cardiovasculares e/ou hipertensao arterial sistemica, que se submetem a tomografia computadorizada de torax e/ou abdomen. Classificados por sexo e faixa etaria (20 a 40 anos, 41 a 60 e mais de 60 anos), calculamos as medias e desvios padrao dos diametros, determinamos os valores maximos e minimos, verificamos a influencia da idade, do sexo e da superficie corporea e determinamos as relacoes entre as medidas dos diametros da aorta toracica ascendente e descendente e da aorta abdominal, concluindo que: tanto a aorta toracica quanto a aorta abdominal reduzem de calibre craniocaudalmente; a superficie corporea tem influencia no tamanho da aorta; seu calibre aumenta com a idade; os diametros sao maiores em homens; as relacoes entre diametros da aorta ascendente e aorta descendente variam conforme sexo e faixa etaria; na aorta abdominal as razoes entre os diametros medidos ao nivel hilos renais e junto a bifurcacao independem de sexo e idade;...