Variation in the Branching Pattern of the Coronary Artery: A Systematic Review on Anatomical Branching Variation
Authors: Vidhale Deepali , Hiware Sanket , Anjum Shabina , Ahmad Arafat , Bayer Sujatha Bangalore , Hardaha Shilpa Rooplal , Begum Yousuf , Ismail Essam Elbadawy , Ali Mohammed Taher , Saffar Radi Ail Mohammed Al 
Published: September 2024

Abstract

Background:
The coronary arteries, being the major vascular channels, are known to affect the complete circulatory system and hemodynamics of the body. However, as a matter of fact, the coronary arteries are known to have many anatomical and developmental variations along all the morphological aspects, which include location of orifices, various routes that the artery and its tributaries follow, and of course, the pattern of branching of the main artery. The developmental anomalies in the arterial structures result in abnormalities of arterial blood flow, hypoxia, and other conditions which may lead to atherosclerosis of the coronary artery. To the best of our knowledge, the current systematic review and meta-analysis aim to assess the association between variations in the branching pattern of the coronary artery. Moreover, we propose future studies to assess the association and preventive strategies for clinicians and various health-care workers.

Methodology:
We performed an electronic search of PubMed, MEDLINE, Cochrane Central Register, EMBASE, Science Citation Index, Web of Science, and Database of Abstracts of Reviews of Effects, and various clinical tribulation registries till 2022. Two independent reviewers extracted the data, and the present meta-analysis was performed with the help of RevMan version 5.4. For the present meta-analysis, we used 10-year database from 2012 to 2022.

Results:
Appropriate data were fetched from studies that were included for the meta-analysis, and the data were presented in tables for evaluation and drawing of accurate results. A total of 904 articles were found after searching all of the major medical databases. Thirteen more sources of reference were included in the search. After primary screening, full text articles of around 148 were analyzed, and among them, 114 were excluded because those articles were in the category of #case series, reports, or #letters to the editors, #animal studies or #irrelevant documents, reporting duplicate documents, or broadcasting a certain variant as opposed to occurrence. After the complete screening and analysis of the data were done, the final number of articles that were included in the meta-analysis was 29 (n = 29).

Conclusion:
The present meta-analysis is an attempt to review and analyze the recent literature published on the variation in anatomy and developmental abnormalities of the coronary arteries in the differing population across the geography of the globe. The structural aspects of the coronary arteries, and not just the lifestyle issues, are the ones which are associated with coronary artery disease (CAD), a major cause of mortality in the population. However, the anatomical factors are not attending limelight as other obesity- or age-related issues for the same. Hence, the present review aimed to deliver a thorough understanding of the most predominant branching pattern of the coronary artery seen among Asian population. This study will be beneficial to cardiologists and radiologists when performing various treatments such as coronary angiograms, coronary angioplasty, bypass grafting, and other medical procedures and can also lead to prevention of the CAD.