Citation, DOI and article data
A bovine arch is apparent in ~15% (range 8-25%) of the population and is more common in individuals of African descent.
A related variant, also known as truncus bicaroticus, is the origin of the left common carotid artery from the brachiocephalic artery but not sharing a true common origin, which occurs in ~9% of the population. Sometimes this can be difficult to distinguish from a common origin because the left common carotid artery arises within 1 cm of the origin of the brachiocephalic artery.
This common variant is asymptomatic most of the time. In rare cases of head and neck surgery, e.g. tracheostomy, it can be a risk factor for injury and cause complications 4. In combination with an aberrant right subclavian artery it can cause a dysphagia lusoria.
History and etymology
The name stems from the similarity of this variant with that of a normal bovine arch. A true bovine arch (as found in cattle) has a common single brachiocephalic trunk which trifurcates into bilateral subclavian arteries and a single bicarotid trunk. This variation is very rare in humans.
Presumably somewhere in the animal kingdom is an animal whose aorta actually branches like the so-called bovine pattern. Proposed names are feline/canine/lapine arch.
The term truncus bicaroticus is also not consistent and can be misleading as the branching pattern not only includes the right and left common carotid artery, but also the right subclavian artery.
Bovine arch is a common misnomer. The preferred terminology is "Common origin of the brachiocephalic artery and left common carotid artery" 5.
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- 3. Müller M, Schmitz BL, Pauls S et-al. Variations of the aortic arch–a study on the most common branching patterns. Acta Radiol. 2011;52 (7): 738-42. Acta Radiol (full text) - doi:10.1258/ar.2011.110013 - Pubmed citation
- 4. Becker C, Csatari Z, Pfeiffer J. Truncus bicaroticus: an underestimated anatomic variation. Laryngoscope. 2014;124 (5): 1141-2. doi:10.1002/lary.24444 - Pubmed citation
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