Related Experiment Video
Updated: Feb 2, 2026
Isolation and Analysis of Aortic Arch and Root Lesions in an Atherosclerotic Mouse Model
Published on: February 14, 2025
Aortic Arch Variants: A Practical Guide to Safe and Timely Catheterization
Maksim Shapiro1, Eytan Raz2, Peter Kim Nelson3
1Departments of Radiology and Neurology, NYU School of Medicine, New York, New York, USA.
Insights
Understanding aortic arch variants is crucial for safe catheterization. This review details common and rare variations to guide emergent procedures without prior imaging, ensuring successful interventions.
Area of Science:
- Cardiovascular Anatomy
- Interventional Cardiology
Background:
- Aortic arch anatomy variations are well-documented across multiple disciplines.
- Limited literature exists on safe catheterization of aortic arch variants, especially during emergent procedures without prior imaging.
Purpose of the Study:
- To address the gap in literature regarding safe and timely catheterization of aortic arch variants.
- To provide guidance for interventionalists encountering unexpected arch anomalies.
Main Methods:
- Review of 1,000 diagnostic and therapeutic catheterizations.
- Identification and categorization of aortic arch variants based on frequency of encounter.
Main Results:
- Presentation of aortic arch variants with illustrations and angiographic images.
- Emphasis on intraprocedural diagnosis and catheterization techniques for safe and efficient procedures.
Conclusions:
- Familiarity with common and rare aortic arch variants is essential.
- A low threshold for aortic arch angiography and proficiency with various catheters ensure procedural success.
- This knowledge aids in managing variations encountered during catheter-based interventions.
Background:
Variations in aortic arch anatomy have been extensively described from multiple perspectives including gross anatomy, embryology, associated cardiac and other anomalies, early life presentation, and cross-sectional diagnosis. There is however a paucity of literature with an emphasis on safe and timely catheterization, particularly when the variants are found during emergent or other catheter angiographic procedures without benefit of prior cross-sectional vascular imaging. The purpose of this review is to try to fill this gap.
Methods:
A review of past 1,000 diagnostic and therapeutic catheterizations was performed to identify arch variants, which are presented in order of frequency encountered at our institutions.
Results:
The variants are presented as illustrations and catheter angiographic images, with emphasis on safe and efficient intraprocedural diagnosis and catheterization.
Conclusion:
Familiarity with more and less common arch variants, along with low threshold for performance of pigtail aortic arch angiography and comfort in use of general purpose and recurved catheters, will ensure success in the vast majority of encountered variations.
Related Concept Videos
01:10The Arch of Aorta
Encircling the heart, the coronary arteries form a ring-like structure before...
01:21Cardiac Catheterization II: Right Heart Catheterization
02:30Histone Variants at the Centromere
01:24Cardiac Catheterization III: Left Heart Catheterization
01:18Guidelines and Strategies for Safe Computer Charting
Maintain Confidentiality and Security:
01:28Cardiac Catheterization I: Pre-Procedure Overview