Duplicated Vertebral Artery : Literature Review and Clinical Significance
1National Medical Center, Seoul, Korea.
Insights
Duplication of the vertebral artery (VA) is a rare vascular anomaly. This study found a 0.295% prevalence, highlighting its clinical significance in diagnosis and treatment.
Area of Science:
- Vascular anatomy
- Embryology
- Medical imaging
Background:
- Vertebral artery (VA) duplication is an uncommon vascular variation.
- Understanding its anatomical and embryological basis is crucial.
Purpose of the Study:
- To describe the anatomy and embryological development of duplicated VAs.
- To review the clinical significance of this rare vascular variant.
Main Methods:
- Computed tomography (CT) angiography was performed on 3386 patients.
- Duplication was defined as a VA with two origins fusing at different neck levels.
Main Results:
- Ten patients (0.295%) exhibited dual VA origins (3 left, 7 right).
- Origins were from the subclavian artery or aortic arch.
- The medial limb's position relative to the common carotid artery (CCA) and vertebral foramen was detailed, with some cases showing proximity to the CCA and its branches.
Conclusions:
- Vertebral artery duplication is typically asymptomatic.
- Clinicians should consider this anomaly during patient diagnosis and treatment planning.
Objective:
Duplication of the vertebral artery (VA) is a rare vascular variant. This paper describes the anatomy and embryological development of duplicated VAs and reviews the clinical significance.
Methods:
Computed tomography (CT) angiography was performed in 3386 patients (1880 females, 1506 males) between March 2014 and November 2015. We defined duplication of the VA as a condition in which the VA has two origins that fused at different levels of the neck.
Results:
Ten of the 3386 patients (0.295%) who received CT angiography had a dual origin of the VA; three on the left side, and seven on the right side. In all seven with right dual origin of the VA, both limbs of the VA origin originated from the right subclavian artery. In all three patients with left dual origin of the VA, both limbs of the VA originated from the left subclavian artery and aortic arch. In all 10 patients, the medial limb of the duplicated VA was located posteriorly and medially to the common carotid artery (CCA) and anteriorly and laterally to the vertebral transverse foramen. In two patients, the medial limb of the duplicated VA was located in close proximity to the CCA. In another two patients, the medial limb of the duplicated VA was located in close proximity to the CCA, carotid bifurcation, and proximal internal carotid artery.
Conclusion:
Although duplication of the VA is asymptomatic in most patients, clinicians should consider this anomaly during diagnosis and treatment.
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