E1790. Pictures Speak a Thousand Words: An Imaging Review of Aortic Arch Anomalies
  1. Taylor Shook ; University of Toledo
  2. Adrian Zhou; University of Toledo
  3. Shamis Hasan; University of Toledo
  4. Sammy Droubi ; University of Toledo
  5. Kevin Guzak; University of Toledo
  6. Patrick Frank ; University of Toledo
  7. Adel Maklad; University of Toledo
Aortic development is a complex process that involves sequential formation and regression of six pairs of primitive embryonic arches. As a result, it is prone to a number of congenital variants and anomalies. Aortic arch anomalies are common findings in radiology, with an estimated prevalence around 20 - 30% in the general population. Although individuals with an aortic arch anomaly are often asymptomatic, they are at a greater risk of developing serious complications than those with a normal three-vessel branching pattern (i.e., in the order of a brachiocephalic trunk, left common carotid artery, and left subclavian artery). The purpose of this exhibit is to review the development and anatomy of the aortic arch, describe the radiological features of aortic arch anomalies, and discuss their clinical implications.

Educational Goals / Teaching Points
This exhibit will first review the embryology and anatomy of normal aortic arch and then present cases of aortic arch variations, including but not limited to, bovine arch, anomalous origins of vertebral arteries, aberrant right subclavian artery, and right arch. Relevant clinical significance will be discussed. Cadaveric pictures will be used to better visualize the variations, as there is supportive evidence for the integration of cadavers in radiology residency training.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
This exhibit will utilize a multimodality approach, including diagrams, cadavers, angiography, and/or CTA/MRA with 3D reconstruction images, to illustrate different aortic arch anomalies.

A strong understanding of the three-dimensional knowledge of aortic arch is fundamental for radiologists. It is also crucial for surgeons and interventionists to consider potential aortic arch variations in preoperative planning, especially for endovascular cases.