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The left common carotid artery branches directly off the transverse aortic arch, and the right common carotid artery branches off the brachiocephalic artery, which originates at the transverse aortic arch.
In another variation, a vein runs from the left brachiocephalic or from the left superior intercostal vein through the ‘vestigial fold’ (of Marshall) of the pericardium to the vein of Marshall to the coronary sinus.
The great cardiac vein then drains into the superior vena cava or left brachiocephalic vein via the oblique vein of Marshall.
Blood supply to the head and upper limbs originates from the aortic arch through three main arteries: the right brachiocephalic artery, the left common carotid and the left subclavian.
Secondary to dissection, narrowing of the trunk arteries of the aortic arch was found in 23 of the autopsied cases involving one or more main branches, most frequently the brachiocephalic and carotid arteries.
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