Skip to main content
Top
Published in: Surgical and Radiologic Anatomy 7/2018

01-07-2018 | Original Article

Prevalence and anatomy of anomalous left vertebral artery originated from aorta evaluated by computed tomographic angiography

Authors: Yunsuk Choi, Sang Bong Chung, Myoung Soo Kim

Published in: Surgical and Radiologic Anatomy | Issue 7/2018

Login to get access

Abstract

Purpose

We evaluated anatomical characteristics and clinical significance of left vertebral artery (VA) originating from aortic arch (AA) by computed tomography (CT) angiography.

Methods

CT angiography was performed in 3460 patients between March 01, 2014 and November 30, 2015. We examined course of prevertebral VA (PVVA) segment and level of entry into the cervical vertebra transverse foramen (CVTF) of left VA originated from AA.

Results

One hundred fifty-three of 3460 patients had left VA originated from AA. Six of 153 patients had dual origin of VA. Entry level to CVTF of 156 left VAs in 153 cases ranged from C3 to C6. Entry level to CVTF of 156 right VAs in 153 cases ranged from C3 to C7. One hundred fifty-six right PVVA segments positioned in longus colli muscle lateral side in 112 VAs, longus colli muscle anterior surface near longus colli muscle lateral margin in 41 VAs, and unknown location in three VAs. One hundred fifty-six left PVVA segments positioned in anterior surface of longus colli muscle midline in 5 cases, anterior surface of longus colli muscle near longus colli lateral margin in 138 cases, longus colli muscle lateral side in 12 cases, and anterior surface of anterior scalene muscle midline in one case.

Conclusions

Left VA may arise from the AA. If a long PVVA segment entering higher CVTF is present, operator can perform anterior cervical surgery via contralateral approach for avoidance of VA injury.
Literature
1.
go back to reference Albayram S, Gailloud P, Wasserman BA (2002) Bilateral arch origin of the vertebral arteries. AJNR 23(3):455–458PubMed Albayram S, Gailloud P, Wasserman BA (2002) Bilateral arch origin of the vertebral arteries. AJNR 23(3):455–458PubMed
3.
go back to reference Einstein EH, Song LH, Villela NL, Fasani-Feldberg GB, Jacobs JL, Kim DO, Nathawat A, Patel D, Bender RB, Peters DF (2016) Anomalous origin of the left vertebral artery from the aortic arch. Aorta (Stamford) 4(2):64–67 Einstein EH, Song LH, Villela NL, Fasani-Feldberg GB, Jacobs JL, Kim DO, Nathawat A, Patel D, Bender RB, Peters DF (2016) Anomalous origin of the left vertebral artery from the aortic arch. Aorta (Stamford) 4(2):64–67
5.
go back to reference Gluncic V, Ivkic G, Marin D, Percac S (1999) Anomalous origin of both vertebral arteries. Clin Anat 12(4):281–284CrossRefPubMed Gluncic V, Ivkic G, Marin D, Percac S (1999) Anomalous origin of both vertebral arteries. Clin Anat 12(4):281–284CrossRefPubMed
6.
go back to reference Golfinos JG, Dickman CA, Zabramski JM, Sonntag VK, Spetzler RF (1994) Repair of vertebral artery injury during anterior cervical decompression. Spine (Phila Pa 1976) 19(22):2552–2556CrossRef Golfinos JG, Dickman CA, Zabramski JM, Sonntag VK, Spetzler RF (1994) Repair of vertebral artery injury during anterior cervical decompression. Spine (Phila Pa 1976) 19(22):2552–2556CrossRef
7.
go back to reference Goray VB, Joshi AR, Garg A, Merchant S, Yadav B, Maheshwari P (2005) Aortic arch variation: a unique case with anomalous origin of both vertebral arteries as additional branches of the aortic arch distal to left subclavian artery. AJNR 26(1):93–95PubMed Goray VB, Joshi AR, Garg A, Merchant S, Yadav B, Maheshwari P (2005) Aortic arch variation: a unique case with anomalous origin of both vertebral arteries as additional branches of the aortic arch distal to left subclavian artery. AJNR 26(1):93–95PubMed
8.
go back to reference Jaffe RB (1991) Radiographic manifestations of congenital anomalies of the aortic arch. Radiol Clin North Am 29(2):319–334PubMed Jaffe RB (1991) Radiographic manifestations of congenital anomalies of the aortic arch. Radiol Clin North Am 29(2):319–334PubMed
10.
go back to reference Jalali Kondori B, Asadi MH, Rahimian E, Tahsini MR (2016) Anatomical variations in aortic arch branching pattern. Arch Iran Med 19(1):72–74PubMed Jalali Kondori B, Asadi MH, Rahimian E, Tahsini MR (2016) Anatomical variations in aortic arch branching pattern. Arch Iran Med 19(1):72–74PubMed
11.
go back to reference Koenigsberg RA, Pereira L, Nair B, McCormick D, Schwartzman R (2003) Unusual vertebral artery origins: examples and related pathology. Catheter Cardiovasc Interv 59(2):244–250CrossRefPubMed Koenigsberg RA, Pereira L, Nair B, McCormick D, Schwartzman R (2003) Unusual vertebral artery origins: examples and related pathology. Catheter Cardiovasc Interv 59(2):244–250CrossRefPubMed
12.
go back to reference Komiyama M, Morikawa T, Nakajima H, Nishikawa M, Yasui T (2001) High incidence of arterial dissection associated with left vertebral artery of aortic origin. Neurol Med Chir (Tokyo) 41(1):8–11 (discussion 11–12) CrossRef Komiyama M, Morikawa T, Nakajima H, Nishikawa M, Yasui T (2001) High incidence of arterial dissection associated with left vertebral artery of aortic origin. Neurol Med Chir (Tokyo) 41(1):8–11 (discussion 11–12) CrossRef
13.
go back to reference Lemke AJ, Benndorf G, Liebig T, Felix R (1999) Anomalous origin of the right vertebral artery: review of the literature and case report of right vertebral artery origin distal to the left subclavian artery. AJNR 20(7):1318–1321PubMed Lemke AJ, Benndorf G, Liebig T, Felix R (1999) Anomalous origin of the right vertebral artery: review of the literature and case report of right vertebral artery origin distal to the left subclavian artery. AJNR 20(7):1318–1321PubMed
14.
go back to reference Lu J, Ebraheim NA (1999) The vertebral artery: surgical anatomy. Orthopedics 22(11):1081–1085PubMed Lu J, Ebraheim NA (1999) The vertebral artery: surgical anatomy. Orthopedics 22(11):1081–1085PubMed
18.
go back to reference Satti SR, Cerniglia CA, Koenigsberg RA (2007) Cervical vertebral artery variations: an anatomic study. AJNR Am J Neuroradiol 28(5):976–980PubMed Satti SR, Cerniglia CA, Koenigsberg RA (2007) Cervical vertebral artery variations: an anatomic study. AJNR Am J Neuroradiol 28(5):976–980PubMed
20.
go back to reference Singla RK, Sharma T, Sachdeva K (2010) “Variant origin of left vertebral artery”. Int J Anat Var 3:97–99 Singla RK, Sharma T, Sachdeva K (2010) “Variant origin of left vertebral artery”. Int J Anat Var 3:97–99
21.
go back to reference Smith MD, Emery SE, Dudley A, Murray KJ, Leventhal M (1993) Vertebral artery injury during anterior decompression of the cervical spine. A retrospective review of ten patients. J Bone Joint Surg Br 75(3):410–415CrossRefPubMed Smith MD, Emery SE, Dudley A, Murray KJ, Leventhal M (1993) Vertebral artery injury during anterior decompression of the cervical spine. A retrospective review of ten patients. J Bone Joint Surg Br 75(3):410–415CrossRefPubMed
23.
go back to reference Vučurević G, Marinković S, Puškaš L, Kovačević I, Tanasković S, Radak D, Ilić A (2013) Anatomy and radiology of the variations of aortic arch branches in 1,266 patients. Folia Morphol (Warsz) 72(2):113–122CrossRef Vučurević G, Marinković S, Puškaš L, Kovačević I, Tanasković S, Radak D, Ilić A (2013) Anatomy and radiology of the variations of aortic arch branches in 1,266 patients. Folia Morphol (Warsz) 72(2):113–122CrossRef
24.
go back to reference Yamashiro S, Kuniyoshi Y, Arakaki K, Inafuku H, Morishima Y, Kise Y (2010) Total arch replacement with associated anomaly of the left vertebral artery. Ann Thorac Cardiovasc Surg 16(3):216–219PubMed Yamashiro S, Kuniyoshi Y, Arakaki K, Inafuku H, Morishima Y, Kise Y (2010) Total arch replacement with associated anomaly of the left vertebral artery. Ann Thorac Cardiovasc Surg 16(3):216–219PubMed
Metadata
Title
Prevalence and anatomy of anomalous left vertebral artery originated from aorta evaluated by computed tomographic angiography
Authors
Yunsuk Choi
Sang Bong Chung
Myoung Soo Kim
Publication date
01-07-2018
Publisher
Springer Paris
Published in
Surgical and Radiologic Anatomy / Issue 7/2018
Print ISSN: 0930-1038
Electronic ISSN: 1279-8517
DOI
https://doi.org/10.1007/s00276-018-2038-9

Other articles of this Issue 7/2018

Surgical and Radiologic Anatomy 7/2018 Go to the issue