Evaluation of Aortic Arch Branching Variations with Computed Tomography Angiographies

Objectives: Typically, aortic arch gives off three branches from proximal to distal: the brachiocephalic trunk, the left common carotid artery, and the left subclavian artery. This study aimed to determine the prevalence of aortic arch (AA) branching variations in a large sample and to assess gender differences.Materials and Methods: This study was conducted as a retrospective, observational radiologic-anatomy. The branching configurations were categorized as follows: Type 1: Normal configuration (left-sided aortic arch with standard branching), Type 2: Bovine arch, Type 3: Left vertebral artery variation, Type 4: Bovine arch with left vertebral artery variation, Type 5: Common origin of the right and left common carotid arteries, Type 6: Aberrant right subclavian artery, and Type 7: Right-sided aortic arch variations.Results: A total of 744 patients (334 females, 44.9% / 410 males, 55.1%) were included in the study. In the study sample, AA was most prevalent in Type 1 branching. Type 1 prevalence rates were 98.2%, 98.3%, and 98.3% in females, males, and the overall population, respectively. Other branching variations encountered in the study were Type 2, Type 3, Type 6, and Type 7. The prevalence of these variations was 1.1%, 0.3%, 0.3%, and 0.1%, respectively. There was no statistically significant difference in the prevalence of branching variations between genders (p>0.05).Conclusions: This study concluded that AA variants were rarely found in the study sample. Although they are often encountered asymptomatically and incidentally, we believe that knowledge of population prevalence differences will contribute to clinical and radiological assessments.