Background

Congenital aortic arch anomalies are commonly encountered during neurointerventional procedures. While some anomalies are identified at an early age, many are incidentally discovered later in adulthood during endovascular evaluations or interventions. Proper understanding of the normal arch anatomy and its variants is pivotal to safely navigate normal aortic arch branches and to negotiate the catheter through anomalies during neurointerventional procedures. This is particularly relevant in the increasingly “transradial first” culture of neurointerventional surgery. Moreover, some of these anomalies have a peculiar predilection for complications including aneurysm formation, dissection, and rupture during the procedure. Therefore, an understanding of these anomalies, their underlying embryological basis and associations, and pattern of circulation will help endovascular neurosurgeons and interventional radiologists navigate with confidence and consider relevant pathologic associations that may inform risk of cerebrovascular disease.

Methods

Here, we present a brief review of the basic embryology of the common anomalies of the aortic arch along with their neurological significances and discuss, through illustrative cases, the association of aortic arch anomalies with cerebral vascular pathology.

Conclusions

Understanding the aortic arch anomalies and its embryological basis is essential to safely navigate the cerebral vascular system during neurointerventional surgeries.

中文翻译：

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主动脉弓异常、胚胎学及其与神经介入手术和中风的相关性：综述

背景

先天性主动脉弓异常是神经介入手术中常见的情况。虽然有些异常是在很小的时候就被发现的，但许多异常是在成年后进行血管内评估或干预时偶然发现的。正确理解正常的主动脉弓解剖结构及其变体对于安全地引导正常的主动脉弓分支以及在神经介入手术期间穿过异常情况的导管至关重要。这在日益“经桡动脉优先”的神经介入手术文化中尤其重要。此外，其中一些异常特别容易出现并发症，包括手术过程中动脉瘤的形成、夹层和破裂。因此，了解这些异常、其潜在的胚胎学基础和关联以及循环模式将有助于血管内神经外科医生和介入放射科医生充满信心地进行导航，并考虑可能告知脑血管疾病风险的相关病理关联。

方法

在这里，我们简要回顾主动脉弓常见异常的基本胚胎学及其神经学意义，并通过说明性病例讨论主动脉弓异常与脑血管病理学的关联。

结论

了解主动脉弓异常及其胚胎学基础对于神经介入手术期间安全导航脑血管系统至关重要。