Variations in the branching mode of the aortic arch in a Malian series: Cadaveric study

Abstract

Background: The aortic arch typically gives off three branches, which are, from right to left, the brachiocephalic trunk, the left common carotid artery, and the left subclavian artery. Variations in these branches are numerous and frequent, and it has been suggested that these variations are more common in the African population. However, data are lacking in the literature for the Malian population. Variations in the branching pattern of the aortic arch can cause dysphagia or dyspnea, or complications during surgical or radiological procedures of thorax and neck.

Methodology: This was a cross-sectional, observational anatomical study conducted at the Anatomy Laboratory of the Faculty of Medicine and Odontostomatology (FMOS) in Bamako. The study spanned a period of 5 years and 4 months, from December 2019 to May 2025. The aortic arch and its branches were dissected after opening the thorax and neck. Fisher’s exact test was used to compare the data by sex.

Results: A total of 69 aortic arches were dissected (58 in men and 11 in women). The classic modality (Type 1) was observed in 43 cases (62.3%). Variations were observed in 26 cases (37.7%). The most common of these variations was the bovine arch (Type 2) with a proportion of 29% (n=20), followed by the association of the bovine arch and the vertebral artery (Type 4) (2.9% or n=2). The other variations were observed, each, in 1 case (1.4%). These were Type 3 (vertebral artery), Type 5 (bicarotid trunk), Type 6 (aberrant right subclavian artery), and a variation that has not been classified, a case where the left vertebral artery and the left subclavian artery originated from the aortic arch by a common trunk. The branching pattern of the aortic arch showed no significant difference according to sex (P > 0.05).

Conclusion: Variations in the branching pattern of the aortic arch are common in the Malian population. Knowledge of these variations is important for vascular surgeons to avoid intraoperative complications during certain procedures such as carotid stenting.