scholarly journals Akutna ishemija lijeve ruke nakon TEVAR-a zbog anatomske varijante vertebralne arterije

2021 ◽  
Vol 57 (3) ◽  
pp. 305-309
Author(s):  
Josip Figl ◽  
Dino Papeš ◽  
Irena Šnajdar ◽  
Tomislav Meštrović ◽  
Predrag Pavić ◽  
...  
Keyword(s):  
Vertebral Artery ◽  
Subclavian Artery ◽  
Multidisciplinary Approach ◽  
Anatomical Variation ◽  
Standard Procedure ◽  
Artery Bypass ◽  
Left Vertebral Artery ◽  
Acute Ischemia ◽  
Aortic Stent Graft ◽  
Procedural Planning

Aim: In this case we report acute left arm ischemia after thoracic endovascular aortic repair of the saccular thoracic aortic aneurysm due to a rare anatomical variation of the left vertebral artery. Case report: Thoracic aortic stent-graft was deployed to cover the aneurysm, but six hours later acute left arm ischemia occurred due to a rare form of vertebral artery origin from the aortic arch instead of from the left subclavian artery. This hostile anatomy led to an iatrogenic acute ischemia which was the indication for an emergency left-common-carotid-to-subclavian-artery bypass grafting. Conclusion: Multidisciplinary approach and careful pre-procedural planning should always be the standard procedure in complex cases to avoid this complication.

scholarly journals Anomalous Origin of the Left Vertebral Artery from the Aortic Arch

Aorta ◽  
2016 ◽  
Vol 04 (02) ◽  
pp. 64-67 ◽  
Author(s):  
Evan Einstein ◽  
Linda Song ◽  
Natalia Villela ◽  
Gregory Fasani-Feldberg ◽  
Jonathan Jacobs ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Vertebral Artery ◽  
Aortic Arch ◽  
Subclavian Artery ◽  
Prevalence Rate ◽  
Left Subclavian Artery ◽  
Anatomical Variation ◽  
Left Vertebral Artery ◽  
Surgical Practice

AbstractAnatomic anomalies of the aortic arch have implications for clinical practice if their significance is understood. Our case study involves a cadaveric finding of the left vertebral artery originating directly from the aortic arch. Although this anatomical variation has been documented, the prevalence of this anomaly may be generally underestimated. After noting this anomaly, we analyzed 27 cases and found that four female cadavers had the left vertebral artery originating from the aortic arch rather than the left subclavian artery. With a prevalence rate of 14.8%, it would seem that this anomaly is more significant than previously thought, which could have implications for surgical practice.

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

ISRN Anatomy ◽  
2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
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.

Non-Standard Management of Target Vessels With the Inner Branch Arch Endograft: A Single-Center Retrospective Study

2021 ◽  
pp. 152660282110586
Author(s):  
Jose I. Torrealba ◽  
Konstantinos Spanos ◽  
Giuseppe Panuccio ◽  
Fiona Rohlffs ◽  
Thomas Gandet ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Vertebral Artery ◽  
Subclavian Artery ◽  
False Lumen ◽  
Aberrant Right Subclavian Artery ◽  
Left Vertebral Artery ◽  
Type I ◽  
Single Center ◽  
Standard Management

Purpose: The purpose of this study was to evaluate early and mid-term results of non-standard management of the supraaortic target vessels with the use of the inner branch arch endograft in a single high-volume center. Material and methods: A single-center retrospective study including all patients undergoing implantation of an inner branch arch endograft from December 2012 to March 2021, who presented a non-standard management of the supraaortic target vessels (any bypass other than a left carotid-subclavian or landing in a dissected target vessel). Technical success, mortality, reinterventions, endoleak (EL), and aortic remodeling at follow-up were analyzed. Results: Twenty-four patients were included. In 17 (71%) cases, the non-standard management was related to innominate artery (IA) compromise (12 with IA dissection, 2 with short IA, 2 with short proximal aortic landing zone that required occlusion of IA, 1 with occluded IA after open arch repair). Two (8%) cases were related to an aberrant right subclavian artery (RSA), 1 patient (4%) due to the concomitant presence of a left vertebral artery (LVA) arising from the arch and an occluded left subclavian artery (LSA), and another patient presented with an occluded LSA distal to a dominant vertebral artery. Three (13%) cases were exclusively related to management in patients with genetic aortic syndromes. Twenty (83%) patients had a previous type A aortic dissection. Ten (42%) patients presented a thoracic or thoracoabdominal aortic aneurysm and 8 (33%) patients an arch aneurysm, 6 of them associated to false lumen (FL) perfusion. There were 2 (8%) perioperative minor strokes, and 1 patient with perioperative mortality. Seven patients presented an early type I endoleak, all resolved at follow-up. Seven patients required reinterventions during follow-up (7 reinterventions related to continuous false lumen perfusion, 3 related to Type Ia endoleak, 2 related to surgical bypass). All patients who presented with FL perfusion had complete FL thrombosis at follow-up. No patient presented aneurysm growth at follow-up. Conclusions: The use of the inner branch arch endograft with a non-standard management of the supraaortic target vessels is a possible option. Despite a high reintervention rate, regression or stability of the aneurysmal diameter was achieved in all the patients with follow-up.

scholarly journals Anomalous Origin of the Vertebral Artery

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.

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

2004 ◽  
Vol 10 (4) ◽  
pp. 309-314 ◽  
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.

scholarly journals Ruptured vertebrobasilar junction aneurysm unmasking subclavian steal syndrome

2020 ◽  
Vol 11 ◽  
pp. 419
Author(s):  
Vivek Murumkar ◽  
Shumyla Jabeen ◽  
Sameer Peer ◽  
Aravinda Hanumanthapura Ramalingaiah ◽  
Jitender Saini
Keyword(s):  
Vertebral Artery ◽  
Subclavian Artery ◽  
Subclavian Steal Syndrome ◽  
Left Vertebral Artery ◽  
Vertebrobasilar Insufficiency ◽  
Subclavian Steal ◽  
Subclavian Artery Occlusion ◽  
Retrograde Filling ◽  
Vertebrobasilar Junction ◽  
Steal Syndrome

Background: Subclavian steal occurs due to stenosis or occlusion of the subclavian artery or innominate artery proximal to the origin of the vertebral artery. Often asymptomatic, the condition may be unmasked due to symptoms of vertebrobasilar insufficiency triggered by strenuous physical exercise involving the affected upper limb. The association of vertebrobasilar junction (VBJ) aneurysms with subclavian steal syndrome has been rarely reported. Hereby, we present a case of VBJ aneurysm associated with subclavian steal treated successfully with endovascular coiling. Case Description: A 65-year-old female presented in the emergency department with acute severe headache and vomiting with no focal neurological deficits. Non-contrast computed tomography of the brain showed modified Fischer Grade 3 subarachnoid hemorrhage. Subsequent digital subtraction angiogram (DSA) showed VBJ aneurysm directed inferiorly with the left subclavian artery occlusion. There was retrograde filling of the left vertebral artery on right vertebral injection, confirming the diagnosis of subclavian steal. Balloon assisted coiling of the VBJ aneurysm was performed while gaining access through the stenotic left vertebral artery ostium which provided a more favorable hemodynamic stability to the coil mass. Conclusion: Subclavian steal exerting undue hemodynamic stress on vertebrobasilar circulation can be an etiological factor for the development of the flow-related aneurysms. Access to the VBJ aneurysms may be feasible through the stenosed vertebral artery if angioplasty is performed before the coiling of the aneurysm.

scholarly journals Morphological characteristics of the aortic arch organization

2013 ◽  
Vol 19 (2) ◽  
pp. 67-73 ◽  
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

scholarly journals Terminal Triplication of the Left Vertebral Artery: A Unique Variation

2007 ◽  
Vol 13 (4) ◽  
pp. 399-401
Author(s):  
P.H. Dissanayake ◽  
J.J. Bhattacharya ◽  
E.V. Teasdale
Keyword(s):  
Vertebral Artery ◽  
Ct Angiography ◽  
Subclavian Artery ◽  
Basilar Artery ◽  
Clinical Importance ◽  
Aberrant Right Subclavian Artery ◽  
Left Vertebral Artery ◽  
Unique Case ◽  
The Right ◽  
Unique Variation

This report describes a unique case of triplication of the terminal left vertebral artery, forming the basilar artery in a 75-year-old male. CT angiography of cranio-cervical vessels also demonstrated the right vertebral artery originating from the right common carotid and an aberrant right subclavian artery. To the best of our knowledge this is the first report of a variation of this nature. The embryology and the clinical importance are discussed.

scholarly journals Vertebral Artery Loops and Cervicobrachial Pain

2020 ◽  
Vol 9 (03) ◽  
pp. 193-196
Author(s):  
Nichanametla Sravani ◽  
Krishnan Nagarajan ◽  
Manchikanti Venkatesh ◽  
Veer S. Negi ◽  
Andi S. Ramesh
Keyword(s):  
Magnetic Resonance ◽  
Vertebral Artery ◽  
Anatomical Variation ◽  
Preoperative Evaluation ◽  
Left Vertebral Artery ◽  
Motor Deficit ◽  
Cervical Cord ◽  
Neurovascular Compression ◽  
Vertebrobasilar Insufficiency ◽  
Loop Formation

AbstractVertebral artery loop formation is an uncommon anatomical variation which may be asymptomatic or can cause cervicobrachial pain, radiculopathy, or even bone erosions and enlargement of neural foramina. As this entity is one of the uncommon causes of cervical radiculopathy, this report aims to create awareness among radiologists and clinicians, as vertebral artery loops may be seen incidentally in routine neuroimaging. magnetic resonance imaging (MRI) with magnetic resonance (MR) angiography or multislice computerized tomography (CT) angiography plays an important role in diagnosing as well as creating a roadmap for the surgery.Vertebral artery loop formation as a cause of radiculopathy is an uncommon condition. An abnormal course of vessel can lead to vascular injury during surgery, hence preoperative evaluation with CT or MRI is essential.1 2 Anomalous looping of vertebral artery can cause neurovascular compression apart from bony erosion, widening of vertebral foramen, and even vertebrobasilar insufficiency. Clinical features of vertebral artery loop formation can be radiculopathy, compression over cervical cord leading to sensory and motor deficit, and vertigo when associated with vertebra–basilar insufficiency, which is known as vascular vertigo. It has also been postulated that loop formation of vertebral artery can also lead to posterior circulation infarcts. Left vertebral artery is more prone for loop formation than the right vertebral artery, probably due to increased caliber in greater proportion of individuals. Multilevel and bilateral tortuosity can occur in younger patients rarely where imaging plays an important role.

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