Bilateral Variation in the Origin and Course of the Vertebral Artery

Understanding the great vessels of the aortic arch and their variations is important for both the endovascular interventionist and the diagnostic radiologist. An understanding of the variability of the vertebral artery remains most important in angiography and surgical procedures where an incomplete knowledge of anatomy can lead to serious implications. In the present case, a bilateral variation in the origin and course of vertebral artery was observed. The left vertebral artery took origin from the arch of aorta and entered the foramen transversarium of the fourth cervical vertebra. The right vertebral artery took origin from the right subclavian artery close to its origin and entered the foramen transversarium of the third cervical vertebra. The literature on the variations of the artery is studied and its clinical significance and ontogeny is discussed.

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Fourth branch of arch of aorta and its clinical implication

Journal of Biomedical Sciences ◽

10.3126/jbs.v2i3.14765 ◽

2016 ◽

Vol 2 (3) ◽

pp. 24-27

Author(s):

Rashmi N Gitte ◽

Chenna Reddy Ganji ◽

Vishal M Salve

Keyword(s):

Vertebral Artery ◽

Aortic Arch ◽

Subclavian Artery ◽

Left Vertebral Artery ◽

Branching Pattern ◽

Human Beings ◽

Vertebral Arteries ◽

Brachiocephalic Trunk ◽

Great Vessels ◽

The Right

In human beings the most common branching pattern of the aortic arch was its division into three great vessels ie the brachiocephalic trunk, left common carotid artery and the subclavian artery. The vertebral arteries arise from the superior aspect of the first part of the subclavian artery. In present case, a left vertebral artery arose from the aortic arch as fourth branch was found. The diameter of left vertebral artery at its origin was 6 mm as compared to the right vertebral artery, which has diameter of 3.5 mm at its origin. In this case left sixth dorsal intersegmental artery might have persisted as first part of vertebral artery hence left vertebral artery arising from arch of aorta. Knowledge of the variations in branching pattern of the aortic arch is important in the diagnosis of intracranial aneurysm after subarachnoid haemorrhage.J. Biomed. Sci. 2015, 2(3):21-23.

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Variant course of right vertebral artery - a case report

National Journal of Clinical Anatomy ◽

10.1055/s-0039-3401767 ◽

2014 ◽

Vol 03 (04) ◽

pp. 237-239

Author(s):

Nirmala D. ◽

Anjali Gupta

Keyword(s):

Case Report ◽

Vertebral Artery ◽

Blood Supply ◽

Subclavian Artery ◽

Surgical Procedures ◽

Cervical Vertebra ◽

Incomplete Knowledge ◽

Male Cadaver ◽

The Right ◽

The Brain

AbstractThe Vertebral artery is the first branch of subclavian artery. It is an important source of blood supply to the brain. During dissection of an adult male cadaver, a unilateral variation in the course of Vertebral artery was found. The right Vertebral artery took origin from the subclavian artery and entered foramen transversarium of fourth cervical vertebra. An understanding of the variability of the Vertebral artery remains most important in angiography & surgical procedures where an incomplete knowledge of its anatomy can lead to complications.

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Anatomical organization of aortic arch variation with embryological basis and clinical application

International Journal of Anatomy and Research ◽

10.16965/ijar.2021.105 ◽

2021 ◽

Vol 9 (1.3) ◽

pp. 7901-7904

Author(s):

Gayathri Pandurangam ◽

◽

D. Naga Jyothi ◽

Asra Anjum ◽

S. Saritha ◽

...

Keyword(s):

Aortic Arch ◽

Clinical Application ◽

Surgical Procedures ◽

Wide Spectrum ◽

Branchial Arch ◽

Left Vertebral Artery ◽

Branching Pattern ◽

Brachiocephalic Trunk ◽

Great Vessels ◽

Arch System

Introduction: The variation in the aortic arch is well known and it has been demonstrated by number of researchers. Changes involved in the development of aortic arch system such as regression, retention or reappearance result in the variation in branching pattern of aortic arch. Variations of the branches of aortic arch are due to alteration of branchial arch arteries during embryonic period. The most common classical branching pattern of the aortic arch in humans comprises of three great vessels, which includes Brachiocephalic trunk, Left Common Carotid artery and Left Subclavian artery. Aim: The study is to determine the embryological basis correlating with clinical application and surgical procedures. Materials and Methods: A study was conducted in 50 formalin fixed cadaveric hearts, during a period of two years. In the routine dissection for 1st MBBS and also museum specimens we encountered 3variations in the branches of arch of aorta. Results: The variations in aortic arch branching pattern were observed in 4 cadaveric hearts (8%). Conclusion: The wide spectrum of variation in the human aortic arch and its branches offer valuable information to catheterize in endovascular surgery for diagnostic and surgical procedures in the thorax, head and neck regions. KEY WORDS: Aortic Arch (AA), Left Common Carotid (LCCA), Left Subclavian (LSA), Brachiocephalic Trunk (BCT), left vertebral artery(LVA).

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Anomalous Origin of the Vertebral Artery

Journal of Morphological Sciences ◽

10.1055/s-0038-1676779 ◽

2018 ◽

Vol 35 (04) ◽

pp. 216-217

Author(s):

André Shinohara ◽

Beatriz Sangalette ◽

Mateus Silva ◽

Laís Rinaldi ◽

Juliane Souza ◽

...

Keyword(s):

Vertebral Artery ◽

Aortic Arch ◽

Subclavian Artery ◽

Surgical Procedures ◽

Foramen Magnum ◽

Left Vertebral Artery ◽

Clear Understanding ◽

Case Presentation ◽

Human Specimen ◽

The Common

Introduction The present article presents a rare case of variation of the left vertebral artery, which originated from the aortic arch, between the common carotid artery and the subclavian artery, although classic descriptions of the vertebral artery indicate its origin at the subclavian artery, where it penetrates the foramen transverse and ascends cervically to the foramen magnum. Case presentation The anatomical peculiarity of the vertebral artery is evidenced. The origin of the vertebral artery was identified directly from the aortic arch in a dissected human specimen. Conclusion In view of the numerous surgical procedures performed in this area, the clear understanding of its topographic layout is indispensable, and might change surgical procedures performed in the region.

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A Five-Vessel Aortic Arch with an Anomalous Origin of Both Vertebral Arteries and an Aberrant Right Subclavian Artery

Interventional Neuroradiology ◽

10.1177/159101990401000404 ◽

2004 ◽

Vol 10 (4) ◽

pp. 309-314 ◽

Cited By ~ 9

Author(s):

P.A. Brouwer ◽

M.P.S. Souza ◽

R. Agid ◽

K.G. terBrugge

Keyword(s):

Carotid Artery ◽

Vertebral Artery ◽

Aortic Arch ◽

Subclavian Artery ◽

Common Carotid Artery ◽

Anomalous Origin ◽

Aberrant Right Subclavian Artery ◽

Left Vertebral Artery ◽

Transverse Foramen ◽

The Right

In this case presentation we describe a patient with an anomalous origin of the right vertebral artery arising from the right common carotid artery in combination with an aberrant right subclavian artery and a left vertebral artery originating from the arch between the left common carotid artery and left subclavian artery. Hence there were five vessels originating from the aortic arch. The possible embryological mechanism as well as a postulation on the importance of the level of entrance of the vertebral artery in the cervical transverse foramen is discussed.

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Morphological characteristics of the aortic arch organization

ARS Medica Tomitana ◽

10.2478/arsm-2013-0012 ◽

2013 ◽

Vol 19 (2) ◽

pp. 67-73 ◽

Cited By ~ 1

Author(s):

A.M. Manole ◽

D.M. Iliescu ◽

R. Baz ◽

P. Bordei

Keyword(s):

Vertebral Artery ◽

Aortic Arch ◽

Subclavian Artery ◽

Left Subclavian Artery ◽

Left Vertebral Artery ◽

Morphological Aspect ◽

Arterial Trunk ◽

Brachiocephalic Trunk ◽

The Right ◽

Number Of Branches

Abstract Our study was performed on 228 cases by dissection, by plastic injection followed by corrosion or dissection and by simple and CT angiography study. Each morphological aspect was assessed on a different numbers of cases, as long as the same case could not provide data on all studied elements. We assessed: the number of branches that originate from the aortic arch, the level of origin and the morphological type of the aortic arch. In terms of number of branches emerging from the aortic arch, most commonly are three branches, in 48.48% of cases, describing them 3 variations: separation of the three classical branches in 45,96% of cases, in 1.51% of cases the left common carotid artery emerged from the brachiocephalic trunk while the other two branches being represented by a vertebral artery and the left subclavian and in 1.01% by the right subclavian artery with retroesophageal traject, by a bicarotid arterial trunk and the left subclavian artery. In 28.70% of the cases were four branches, as follows: in 13.13% of cases the fourth branch was represented by the left vertebral artery, in 7.07% of cases there was the inferior thyroid artery, in 4.04% of cases the brachiocephalic arterial trunk was missing and the right subclavian artery originate from the aortic arch and presented a retroesophageal traject, in 3.03% of cases the fourth artery was the ascending cervical and in 1.51% of cases all four arteries had their origins in the aortic arch with no brachiocephalic trunk. In 22.73% of cases from the aortic arch originated only two branches: in 19.70% of cases the left common carotid originated in the brachiocephalic trunk, so the second branch was the left subclavian and in 3.03% of the cases there were two brachiocephalic trunks. Regarding the level of origin from the aortic arch, we found that only the brachiocephalic arterial trunk showed versions of origin: in 64 61% of the cases the brachiocephalic trunk had its origin in the horizontal segment of the aortic arch, in 21.54% of cases the origin was located at the limit between the ascending and horizontal segments and vin 12.31% of cases the origin was from the ascending segment of the aortic arch. In only 1.54% of the cases the left subclavian artery originated from the descending segment of the aortic arch

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Retroesophageal right subclavian artery associated with a bicarotid trunk and an ectopic origin of vertebral arteries

Surgical and Radiologic Anatomy ◽

10.1007/s00276-021-02746-1 ◽

2021 ◽

Author(s):

Barbara Buffoli ◽

Vincenzo Verzeletti ◽

Lena Hirtler ◽

Rita Rezzani ◽

Luigi Fabrizio Rodella

Keyword(s):

Carotid Artery ◽

Vertebral Artery ◽

Aortic Arch ◽

Subclavian Artery ◽

Common Carotid Artery ◽

Distal Part ◽

Aberrant Right Subclavian Artery ◽

Left Vertebral Artery ◽

Vertebral Arteries ◽

The Right

AbstractA rare branching pattern of the aortic arch in a female cadaver is reported. An aberrant right subclavian artery originated from the distal part of the aortic arch and following a retroesophageal course was recognized. Next to it, from the left to the right, the left subclavian artery and a short bicarotid trunk originating the left and the right common carotid artery were recognized. An unusual origin of the vertebral arteries was also identified. The left vertebral artery originated directly from the aortic arch, whereas the right vertebral artery originated directly from the right common carotid artery. Retroesophageal right subclavian artery associated with a bicarotid trunk and ectopic origin of vertebral arteries represents an exceptional and noteworthy case.

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Anomalous origin of the left vertebral artery in humans: A rare anatomical finding?

International Journal of Basic and Applied Sciences ◽

10.14419/ijbas.v4i2.4615 ◽

2015 ◽

Vol 4 (2) ◽

pp. 224

Author(s):

José Aderval Aragão ◽

Júlio César Claudino dos Santos ◽

Dhayanna Rolemberg Gama Cabral ◽

Carlos Augusto de Oliveira Filho ◽

Henrique Pereira Barros

Keyword(s):

Vertebral Artery ◽

Aortic Arch ◽

Single Case ◽

Case Reports ◽

Anatomical Variation ◽

Cervical Vertebra ◽

Anomalous Origin ◽

Left Vertebral Artery ◽

Endovascular Interventions ◽

Small Series

<p>Context: Anatomical and morphological variations of the aortic arch and its branches are important in relation to thoracic and neck surgery. However, developmental abnormalities of the vertebral arteries are generally considered to be very rare. They have mostly been described in single case reports or small series. Thus, there is a need for further knowledge as an aid in planning surgery on the aortic arch or endovascular interventions. Objective: To report on a case of anomalous origin in the left vertebral artery. Case report: In a male cadaver, a left vertebral artery with its origin in the aortic arch between the left common carotid and left subclavian arteries was observed. Its length was 120 mm, and its diameter was 5.5 mm. It entered the transverse foramen of the third cervical vertebra. Conclusion: Knowledge of the anatomical variation of the origin of the vertebral artery is important not only diagnostically but also in planning surgery on the aortic arch or endovascular interventions.</p>

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Morphology of the vertebral artery in Asian population

Asian Journal of Medical Sciences ◽

10.3126/ajms.v5i4.6150 ◽

2014 ◽

Vol 5 (4) ◽

pp. 84-88 ◽

Cited By ~ 1

Author(s):

Maryna Alfaouri-Kornieieva ◽

Azmy M Al-Hadidi

Keyword(s):

Vertebral Artery ◽

Asian Population ◽

Outer Diameter ◽

Medical Sciences ◽

The Third ◽

Asian Patients ◽

Distal Loop ◽

The Right ◽

Occipital Lobes ◽

The Brain

Background: Recent clinical trials have shown a rising trend of stroke in Asian population. Approximately 20% strokes of total occur at the vertebrobasilar basin that supplies the occipital lobes of the brain, the cerebellum, and the brainstem. The anatomical features and variability of the third segment of the vertebral artery (VA) in Asians are analyzed in this study. Methods: A prospective cohort study of 68 consecutive Asian patients underwent MRA examination for head and neck in the Department of Radiology of Hospital of University of Jordan from 1.10.2011 to 30.04.2012. The 116 VA were analyzed on the obtained angiograms. Results: The third segment (V3) of the VA was studied according to its conventional division into vertical, horizontal, and oblique parts. The mean outer diameter of the V3 varied up 3.18 ± 0.73 to 4.28 ± 1.08 mm. The parameter prevailed on the left in 91% cases and was greater in males, than in females. The distal loop of the VA projected downward in 26 cases on the right (78%) and in 28 cases on the left (74%). The tortuosity of loop?formations of V3 was evaluated subject to angles between their ascending and descending bends. Conclusion: In comparison with other ethnic groups, the V3 of the VA in Asians has lesser outer diameter, especially along its oblique part; the zero?distance between the occipital bone and horizontal segment of VA occurs more often (up to 26%); the Lang’s III type of V3 variability is the most common in Asians. DOI: http://dx.doi.org/10.3126/ajms.v5i4.6150 Asian Journal of Medical Sciences 2014 Vol.5(4); 84-88

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Anatomical Variations in the Branching Pattern of Human Aortic Arch: A Cadaveric Study from Central India

ISRN Anatomy ◽

10.5402/2013/828969 ◽

2013 ◽

Vol 2013 ◽

pp. 1-5 ◽

Cited By ~ 4

Author(s):

Virendra Budhiraja ◽

Rakhi Rastogi ◽

Vaishali Jain ◽

Vishal Bankwar ◽

Shiv Raghuwanshi

Keyword(s):

Carotid Artery ◽

Vertebral Artery ◽

Aortic Arch ◽

Subclavian Artery ◽

Common Carotid Artery ◽

Left Subclavian Artery ◽

Left Vertebral Artery ◽

Common Trunk ◽

Branching Pattern ◽

Brachiocephalic Trunk

Variations of the branches of aortic arch are due to alteration in the development of certain branchial arch arteries during embryonic period. Knowledge of these variations is important during aortic instrumentation, thoracic, and neck surgeries. In the present study we observed these variations in fifty-two cadavers from Indian populations. In thirty-three (63.5%) cadavers, the aortic arch showed classical branching pattern which includes brachiocephalic trunk, left common carotid artery, and left subclavian artery. In nineteen (36.5%) cadavers it showed variations in the branching pattern, which include the two branches, namely, left subclavian artery and a common trunk in 19.2% cases, four branches, namely, brachiocephalic trunk, left common carotid artery, left vertebral artery, and left subclavian artery in 15.3% cases, and the three branches, namely, common trunk, left vertebral artery, and left subclavian artery in 1.9% cases.

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