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The so-called “bovine aortic arch”: a possible biomarker for embolic strokes?

  • Diagnostic Neuroradiology
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Abstract

Purpose

To examine the prevalence of the so-called bovine aortic arch variation (common origin of the brachiocephalic trunk and the left common carotid artery) in embolic stroke patients, compared with a control group.

Methods

Aortic arch branching patterns were retrospectively evaluated in 474 individuals with (n = 152) and without (n = 322) acute embolic stroke of the anterior circulation. Contrast-enhanced CT scans of the chest and neck (arterial contrast phase, 1–2-mm slice thickness) were used to evaluate aortic arch anatomy. The stroke cohort included 152 patients who were treated for embolic strokes of the anterior circulation between 2008 and 2018. A total of 322 randomly selected patients who had received thoracic CT angiographies within the same time frame were included as a control group.

Results

With a prevalence of 25.7%, the bovine aortic arch variant was significantly more common among patients suffering from embolic strokes, compared with 17.1% of control patients (p = 0.039, OR = 1.67, 95%CI = 1.05–1.97). Stroke patients were more likely to show the bovine arch subtype B (left common carotid artery originating from the brachiocephalic trunk instead of the aortic arch) (10.5% vs. 5.0%, p = 0.039, OR = 2.25, 95%CI = 1.09–4.63), while subtype A (V-shaped common aortic origin of the brachiocephalic trunk and the left carotid) was similarly common in both groups. There was no significant difference regarding the frequency of other commonly observed variant branching patterns of the aortic arch.

Conclusion

The bovine aortic arch, particularly the bovine arch subtype B, was significantly more common among embolic stroke patients. This might be due to altered hemodynamic properties within the bovine arch.

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Funding

No funding was received for this study.

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Authors and Affiliations

  1. Institute for Diagnostic Radiology and Neuroradiology, Greifswald University Hospital, Ferdinand-Sauerbruch-Straße, 17475, Greifswald, Germany

    Annika Syperek, Marie-Luise Kromrey, Norbert Hosten & Michael Kirsch

  2. Department of Neurology, Greifswald University Hospital, Greifswald, Germany

    Anselm Angermaier

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  1. Annika Syperek
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Correspondence to Annika Syperek.

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All procedures performed in the studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Syperek, A., Angermaier, A., Kromrey, ML. et al. The so-called “bovine aortic arch”: a possible biomarker for embolic strokes?. Neuroradiology 61, 1165–1172 (2019). https://doi.org/10.1007/s00234-019-02264-3

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  • DOI: https://doi.org/10.1007/s00234-019-02264-3

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