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Bovine Arch and Stroke Laterality.

Jason D Matakas1, Menachem M Gold2, Jonathan Sterman1

  • 1Department of Radiology Montefiore Medical Center Albert Einstein College of Medicine Bronx NY.

Journal of the American Heart Association
|June 20, 2020
PubMed
Summary
This summary is machine-generated.

Bovine aortic arch anatomy is linked to a higher incidence of left-sided cardioembolic strokes. Understanding this connection may improve stroke prediction and prevention strategies.

Keywords:
aortic archembolic strokeischemic stroke

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Area of Science:

  • Neurology
  • Cardiology
  • Anatomy

Background:

  • Left-hemispheric strokes are more common and severe than right-hemispheric strokes.
  • Aortic arch anatomy may influence cardioembolic stroke laterality.
  • The bovine arch, a common variant, warrants investigation for its role in stroke patterns.

Purpose of the Study:

  • To determine if aortic arch anatomy, specifically the bovine arch, affects the laterality of cardioembolic strokes.
  • To investigate the association between bovine versus standard aortic arch and left- vs. right-hemispheric stroke distribution.

Main Methods:

  • Retrospective analysis of 1598 acute cardioembolic strokes in patients with atrial fibrillation.
  • Inclusion of patients with anterior circulation ischemic infarcts and available arch/brain imaging.
  • Classification of aortic arches as standard or bovine, and strokes as left, right, or bilateral.

Main Results:

  • The study included 615 patients (mean age 77 years, 61% women).
  • Bovine arches (n=191) were associated with a higher proportion of left-sided strokes (51.3%) compared to standard arches (n=424) (43.6%) (P=0.018).
  • A significant association was found between black race and bovine arch (P=0.0001).

Conclusions:

  • Bovine aortic arch configuration is significantly associated with left hemispheric laterality of cardioembolic stroke.
  • Aortic arch anatomy is a determinant of stroke laterality.
  • Further research is needed to explore the hemodynamic factors underlying this association.