A systematic classification of the left-sided aortic arch variants based on cadaveric studies’ prevalence: Response
Letter to the Editor
Surgical and Radiologic Anatomy
School of Medical and Health Sciences
Dear Editor-in-Chief, Surgical and Radiologic Anatomy We read with interest the manuscript titled “A systematic classification of the left-sided aortic arch variants based on cadaveric studies’ prevalence” by K Natsis et al. published in the third issue of Surgical and Radiologic Anatomy in 2021 . The authors undertook a systematic review and meta-analysis of all published cadaveric studies between 1844 and 2019 reporting variation in the branching patterns of the left-sided aortic arch. The results revealed that the standard branching pattern of three separate branches arising from the arch, namely the brachiocephalic trunk, left common carotid artery, and left subclavian artery, had a pooled prevalence of 78 % (95 % CI 72 – 84 %). All variant patterns had a combined prevalence of 22 % (95 % CI 16 – 29 %). In addition, the authors proposed a new classification system, which is based on the number and order of branches arising from the arch, and the reported prevalence of each pattern. The authors concluded that variant branching patterns were more prevalent in females (23 %) than in males (19 %), and more common in individuals of African descent. While several articles describing variant patterns in American individuals of African descent are included, only one article from Africa was included in the systematic review and meta-analysis .