High Incidence of Aortic Arch Anomalies in Patients with Intracerebral Large Vessel Occlusion—a Case Series Report

Tal Granek 2 Ronen Levite 1 Shani Avnery-Kalmanovich 3 Miriam Klar 2 Eugenia Belenky 2 Sigal Tal 2
1Department of Invasive Neuroradiology, Assaf Harofeh Medical Center, Israel
2Department of Radiology, Assaf Harofeh Medical Center, Israel
3Department of Neurology, Assaf Harofeh Medical Center, Israel

PURPOSE: Aortic arch anomalies (AAA) are common and considered benign variants, despite them being associated with various complications. Neurological complications in patients with AAA have been described, but more detailed explanations in literature are lacking. After noticing increased frequency of AAAs in stroke patients during our work, we planned the current study aiming to assess the meaning of this observation.

METHODS: A retrospective analysis of all patients presenting to our institution from January 2015 through December 2016 with large vessel occlusion stroke. Computed tomography angiography scans were reanalyzed for the presence or absence of bovine aortic arches. Frequency of this arch anomaly was calculated and compared to the overall population frequency, which literature on the topic assesses to be 15%.

RESULTS: The final patient population had a mean age of 77.7 years (standard deviation = 8.86) and 62.5% were male. Fifty-one patients presented with large vessel occlusion, 16 of whom had a bovine aortic arch, for a frequency of 31.4%. Frequency comparisons indicate a significantly higher frequency of large vessel occlusion in patients with bovine aortic arch compared to the general population bovine aortic arch frequency (p=.032).

CONCLUSION: This suggests that AAA is associated with large vessel occlusion strokes, and that in the presence of AAA extra caution and preventative stroke measures might be considered.

Tal Granek
Tal Granek