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 Embryology of the Vascular System

1. Embryologic development

  • Initial formation of the vascular system (arteries and veins).
  • Development of the aortic arch.
  • Development of the thoracic and abdominal aorta.
  • Development of the arteries to the extremities.
  • Development of the superior vena cava.
  • Development of the inferior vena cava.

2. Embryologic anomalies

Aortic arch anomalies (including double aortic arch, right aortic arch, retroesophageal right subclavian artery, absence of the internal carotid artery, patent ductus arteriosus and coarctation of the aorta).

Lower extremity arterial anomalies (including persistent sciatic artery, single umbilical artery, and popliteal entrapment syndrome).

Superior vena cava anomalies (including double superior vena cava and left-sided superior vena cava).

Inferior vena cava anomalies (including transposition or left-sided inferior vena cava, retroaortic left renal vein, circumaortic left renal vein, retrocaval ureter and absent suprarenal inferior vena cava).

References

Skandalakis JE, Gray SW eds. Embryology for surgeons: the embryological basis for the treatment of congenital anomalies. Baltimore : Williams & Wilkins, 1994.

Against a background of normal embryology, the authors describe the specific pathological conditions and critically review the embryogenesis of a large number of congenital defects, supplying estimates of their frequency, their distribution within the population, and their prognosis. The diagnostic approach and the principles underlying their surgical correction are also discussed.

Richardson JV, Doty DB, Rossi NP, Ehrenhaft JL. Operation for aortic arch anomalies. Ann Thorac Surg 1981;31:426-432.

This paper reviews a 30-year experience of a single center with aortic arch anomalies. Their clinical presentation, diagnosis and treatment are also briefly reviewed.

Brantley SK , Rigdon EE, Raju S. Persistent sciatic artery: embryology, pathology, and treatment. J Vasc Surg 1993;18:242-248.

This article describes the embryologic development and anomalous persistence of the sciatic artery, the pathologic changes that may occur in the persistent sciatic artery and the management of complications related to these pathologic changes.

Lambert AW, Wilkins DC . Popliteal artery entrapment syndrome. Br J Surg 1999;86:1365-1370.

Popliteal entrapment is an uncommon condition that may cause claudication in young males, some of whim have normal resting pedal pulses. This article reviews popliteal artery entrapment syndrome; it includes the embryology of the arterial supply to the leg and the non-invasive imaging techniques now used in the diagnosis of the condition.

Giordano JM, Trout HH 3rd. Anomalies of the inferior vena cava. J Vasc Surg 1986;3:924-928.

Anomalies of the inferior vena cava are uncommon but important entities to the radiologist and the vascular surgeon. Improper embryogenesis of the inferior vena cava may result in four anatomic anomalies: duplication of the inferior vena cava, transposition or left-sided inferior vena cava, retroaortic left renal vein and circumaortic left renal vein. This paper presents two patients with inferior vena cava anomalies and reviews the embryologic basis and the diagnosis of these rare clinical entities.

Posted June 2010