Compressed Branching Geometry in a Bovine-Type Aortic Arch: A Morphometric Cadaveric Case Report and Systematic Review of the Literature
- 1Medicine, San Juan Bautista School of Medicine, Caguas, PRI
Abstract
Anatomical variation in aortic arch branching is common and clinically significant, yet specimen-level morphometric characterization of a bovine-type aortic arch (BAA) remains scarce. We report a two-branch bovine-type arch that was identified during cadaveric dissection of a formalin-embalmed male decedent in his late 70s. The left common carotid artery arose proximally from the brachiocephalic trunk, which then bifurcated into the right common carotid and right subclavian arteries; the left subclavian artery arose separately from the arch. We contextualized this finding by conducting a systematic review of cadaveric studies reporting the same configuration. Five database sources yielded 191 records, of which 14 cadaveric studies met the eligibility criteria and were appraised using two Joanna Briggs Institute (JBI) critical-appraisal instruments.
The specimen's brachiocephalic trunk measured 18.73 mm externally, which falls within the 18.39-18.84 mm external-diameter range reported in the bovine cadaveric literature. Its luminal diameter measured 17.1 mm, which was also within the corresponding 16.85-17.35 mm range. This caliber may reflect a vessel accommodating combined bilateral carotid perfusion, rather than a pathological dilatation. The single interostial distance between the brachiocephalic trunk and the left subclavian artery measured 7.18 mm externally and 8.5 mm endoluminally. The endoluminal measurement was 34.2% below the 12.91 mm reported in a prior cadaveric BAA specimen and 11.5% below the 9.6 mm mean reported in the only bovine cadaveric series that reported this parameter, with both measured endoluminally. The measured carotid take-off length of 8.01 mm fell within, but near the lower limit of, the range reported across five previously published cadaveric bovine studies (6.0-17.3 mm).
The mid-arch diameter measured 25.18 mm, 16.1% below the reported male mean that was obtained at the corresponding anatomical plane using outer-wall measurements. The arch showed proximal-to-distal tapering without aneurysmal ectasia, mural thrombus, or atherosclerotic calcification. Four of the prior included studies reported BAA-specific morphometry that could be interpreted against a stated convention. The reported interbranch distances varied by more than sixfold; heterogeneous measurement methodologies likely contributed substantially to this apparent variability, as most studies did not define their anatomical landmarks. Harmonizing three series with disparate measurement conventions to a common landmark framework yielded closely concordant interbranch distances. The compact BAA branching geometry observed here may be relevant to the available anatomical corridor during arch and carotid interventions, although clinical consequences cannot be inferred from this limited dataset. Standardized measurement protocols with explicitly defined anatomical landmarks are therefore necessary to enable meaningful cross-study morphometric comparisons.
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BibTeX
@article{naoun2026compressed,
title = {{Compressed Branching Geometry in a Bovine-Type Aortic Arch: A Morphometric Cadaveric Case Report and Systematic Review of the Literature}},
author = {Adrian A Naoun and Hector L Figueroa Monsanto and Wilson Veras},
journal = {Cureus},
year = {2026},
month = sep,
doi = {10.7759/cureus.117241},
url = {https://europepmc.org/article/PMC/PMC13722368},
note = {CC BY},
}
RIS
TY - JOUR
TI - Compressed Branching Geometry in a Bovine-Type Aortic Arch: A Morphometric Cadaveric Case Report and Systematic Review of the Literature
AU - Adrian A Naoun
AU - Hector L Figueroa Monsanto
AU - Wilson Veras
PY - 2026
DA - 2026/09/30
JO - Cureus
DO - 10.7759/cureus.117241
UR - https://europepmc.org/article/PMC/PMC13722368
AB - Anatomical variation in aortic arch branching is common and clinically significant, yet specimen-level morphometric characterization of a bovine-type aortic arch (BAA) remains scarce. We report a two-branch bovine-type arch that was identified during cadaveric dissection of a formalin-embalmed male decedent in his late 70s. The left common carotid artery arose proximally from the brachiocephalic trunk, which then bifurcated into the right common carotid and right subclavian arteries; the left subclavian artery arose separately from the arch. We contextualized this finding by conducting a systematic review of cadaveric studies reporting the same configuration. Five database sources yielded 191 records, of which 14 cadaveric studies met the eligibility criteria and were appraised using two Joanna Briggs Institute (JBI) critical-appraisal instruments. The specimen's brachiocephalic trunk measured 18.73 mm externally, which falls within the 18.39-18.84 mm external-diameter range reported in the bovine cadaveric literature. Its luminal diameter measured 17.1 mm, which was also within the corresponding 16.85-17.35 mm range. This caliber may reflect a vessel accommodating combined bilateral carotid perfusion, rather than a pathological dilatation. The single interostial distance between the brachiocephalic trunk and the left subclavian artery measured 7.18 mm externally and 8.5 mm endoluminally. The endoluminal measurement was 34.2% below the 12.91 mm reported in a prior cadaveric BAA specimen and 11.5% below the 9.6 mm mean reported in the only bovine cadaveric series that reported this parameter, with both measured endoluminally. The measured carotid take-off length of 8.01 mm fell within, but near the lower limit of, the range reported across five previously published cadaveric bovine studies (6.0-17.3 mm). The mid-arch diameter measured 25.18 mm, 16.1% below the reported male mean that was obtained at the corresponding anatomical plane using outer-wall measurements. The arch showed proximal-to-distal tapering without aneurysmal ectasia, mural thrombus, or atherosclerotic calcification. Four of the prior included studies reported BAA-specific morphometry that could be interpreted against a stated convention. The reported interbranch distances varied by more than sixfold; heterogeneous measurement methodologies likely contributed substantially to this apparent variability, as most studies did not define their anatomical landmarks. Harmonizing three series with disparate measurement conventions to a common landmark framework yielded closely concordant interbranch distances. The compact BAA branching geometry observed here may be relevant to the available anatomical corridor during arch and carotid interventions, although clinical consequences cannot be inferred from this limited dataset. Standardized measurement protocols with explicitly defined anatomical landmarks are therefore necessary to enable meaningful cross-study morphometric comparisons.
SN - 2168-8184
ER -