Emrah Keskin, Gökhan Özdemir, Mehmet Selim Gel, Evren Aydoğmuş
Southern Clinics of Istanbul Eurasia - 2025;36(4):323-330
Objective: Complex aortic arch anatomy increases technical difficulties in acute ischemic stroke interventions. We hypothesized that aortic arch variations correlate with patient age and atherosclerotic burden in thrombectomy and intraarterial thrombolytic therapy (IAT) patients. Methods: This retrospective study analyzed aortic arch morphology in 63 consecutive patients (39 males, 24 females; median age 72 years) who underwent thrombectomy and IAT for acute ischemic stroke. Aortography was systematically performed before intervention to classify arch types (I, II, III) and identify bovine arch variants. Statistical analysis examined relationships between arch variations, patient demographics, and risk factors. Results: Type II arch was most prevalent (37 patients, 58.7%), followed by Type I (13 patients, 20.6%) and Type III (13 patients, 20.6%). Bovine arch occurred in 16 patients (25.4%). Patients with Type II/III arches were significantly older than those with Type I (p=0.028). Aortic plaque presence strongly correlated with arch type (p<0.001), with 92.3% of Type III patients having plaques versus 7.7% of Type I patients. Procedural success was achieved in 59/63 cases (93.7%). Conclusion: This retrospective analysis demonstrates that aortic arch variations increase with age and correlate with atherosclerotic burden. Type II and III arches predominate in stroke intervention patients, requiring specialized catheter techniques while maintaining high procedural success rates.
