Verification of aortic arch variations through modern imaging

다국어 초록 (Multilingual Abstract)

The aortic arch with its vessels offers one of the biggest varieties of branching patterns, which is barely beeing mentioned in modern medical textbooks though. The last big survey on the most common varieties had been published by Lippert in 1967 and, since then, not been verified, just republished. With these varieties being of great importance in certain fields of medicine, the up‐to‐dateness of Lippert’s data has been analysed.
The main objective is the analysis of CT‐Angiographies for branching varieties of the aortic arch and comparison of frequency distributions with Lippert 1967. The secondary objective is measuring the vessel lumen of varieties and comparison with matches of the standard variant to find out if varieties have influence on the vessel’s lumen.
This retrospective cross‐sectional study includes 400 patients, more specificaly their CTAs from 01.01.2017 to 31.12.2017, obtained from the University Department of Biomedical Imaging and Image‐guided therapy, General Hospital Vienna. Incusion and exclusion criteria have been differently set up for main and secondary objective. Patients for the main objective have been excluded if they have had any kind of surgery altering their varieties, like bypass‐surgery. Patients for the secondary objective have have been excluded if they were under the age of 18 or have had any kind of diseases/surgery altering the supraaortic vessel’s lumen.
The main objective has been represented with tabular comparisons. For the secondary objective patients not fulfilling the criteria have been excluded at first. Afterwards the different groups of varieties have been matched with groups of the standard variant similiar in age and distribution of sex. The vessel’s lumen then has been analysed and t‐tested.
The analysis and comparison of data in terms of frequency have been proved statistically in‐significant. Testing of V2_TBv with V1_TB (p<0,001; α=0,05) as well as V2_ACCS with V1_ACCS (p<0,001; α=0,05) have shown statistical significance.
Despite minor deviation after analysis with modern imaging the data of Lippert from 1967 can still be seen as up‐to‐date. In vascular surgery it may be neccessary to be considerate about the vessel lumen in case of any known variety of the branches of the aortic arch. Certain questions may ask for more detailed analysis.