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

Q3 Medicine Acta medica academica Pub Date : 2023-04-01 DOI:10.5644/ama2006-124.402

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

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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 description: 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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头臂躯干变异起源与高程:两例尸体。

目的:本报告描述了两个罕见的尸体发现左侧头臂干(BCT)与气管的关系，以及它在胸骨上切迹(SN)上方的高程。病例描述:在两例死后解剖的老年供体中，发现左侧BCT呈高骑程(SN上方0.5和0.8 cm)。BCT起源于主动脉弓，与左侧颈总动脉共同，比典型的左侧位置更远，并在气管前方交叉。1例升、降主动脉及左锁骨下动脉动脉瘤样扩张。在这两种情况下，气管移位到右侧，并有狭窄，由于慢性压迫。结论:高位BCT具有重要的临床意义，因为它可能导致气管切开术、甲状腺手术和纵隔镜检查的并发症，导致致命的并发症。当血管穿过气管前壁时，BCT损伤导致颈部剥离(VI级)时大量出血。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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