The Brachiocephalic Trunk Variant Origin and High-Riding Course: Two Cadaveric Cases

George  Tsakotos; Theano  Demesticha; Vasilios  Karampelias; Konstantinos  Natsis; Vasilios  Protogerou; Dimitrios  Schizas; Ilenia  Chatziandreou; Georgia  Kostare; Maria  Piagkou

doi:10.5644/ama2006-124.402

The Brachiocephalic Trunk Variant Origin and High-Riding Course: Two Cadaveric Cases

Authors

George Tsakotos Department of Anatomy, School of Medicine, National and Kapodistrian University of Athens, Athens
Theano Demesticha Department of Anatomy, School of Medicine, National and Kapodistrian University of Athens, Athens
Vasilios Karampelias Department of Anatomy, School of Medicine, National and Kapodistrian University of Athens, Athens
Konstantinos Natsis Department of Anatomy and Surgical Anatomy, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki
Vasilios Protogerou Department of Anatomy, School of Medicine, National and Kapodistrian University of Athens, Athens
Dimitrios Schizas First Department of Surgery, School of Medicine, Laikon General Hospital, National and Kapodistrian University of Athens, Athens
Ilenia Chatziandreou Department of Internal Pathology, Medical School, Faculty of Health Sciences, National and Kapodistrian University of Athens, Athens
Georgia Kostare Department of Anatomy, School of Medicine, National and Kapodistrian University of Athens, Athens
Maria Piagkou Department of Anatomy, School of Medicine, National and Kapodistrian University of Athens, Athens

DOI:

https://doi.org/10.5644/ama2006-124.402

Keywords:

High-Riding Brachiocephalic Trunk, Innominate Artery, Variant, Compression, Trachea

Abstract

Objective. The current report describes two rare cadaveric findings of a left sided brachiocephalic trunk (BCT) in relation to the trachea, and its high-riding course above the suprasternal notch (SN).

Cases Descriptions. In two elderly body donors dissected after death, a left-sided BCT was identified with a high-riding course (0.5 and 0.8 cm above the SN). The BCT originated from the aortic arch, in common with the left common carotid artery, more distally than the typical left-side location and crossed in front of the trachea. In the 1st case, the ascending and descending aortae, and the left subclavian artery had aneurysmal dilatation. In both cases, the trachea was displaced to the right side and had a stenosis due to the chronic compression.

Conclusion. A high-riding BCT is of paramount clinical importance, as it may complicate tracheotomy, thyroid surgery and mediastinoscopy, leading to fatal complications. BCT injury leads to a massive bleeding during neck dissection (level VI), when the vessel crosses the anterior tracheal wall.

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2023-06-11

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Tsakotos, G. ., Demesticha, T. ., Karampelias, V. ., Natsis, K. ., Protogerou, V. ., Schizas, D. ., … Piagkou, M. . (2023). The Brachiocephalic Trunk Variant Origin and High-Riding Course: Two Cadaveric Cases. Acta Medica Academica, 52(1), 51–55. https://doi.org/10.5644/ama2006-124.402

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Vol. 52 No. 1 (2023)

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Clinical Medicine

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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

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The Brachiocephalic Trunk Variant Origin and High-Riding Course: Two Cadaveric Cases

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