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

Yunsuk Choi1, Sang Bong Chung1, Myoung Soo Kim2

  • 1Department of Neurosurgery, National Medical Center, Euljiro 245, Jung-gu, Seoul, 04564, Republic of Korea.

Surgical and Radiologic Anatomy : SRA
|May 26, 2018
PubMed

Insights

The left vertebral artery (VA) can originate from the aortic arch (AA). Awareness of its anatomical course is crucial for safe anterior cervical spine surgery to prevent VA injury.

Area of Science:

  • Anatomy
  • Vascular Surgery
  • Radiology

Background:

  • The vertebral artery (VA) typically arises from the subclavian artery.
  • Variations in VA origin, such as from the aortic arch (AA), can have significant clinical implications.

Purpose of the Study:

  • To evaluate the anatomical characteristics of the left VA originating from the AA.
  • To determine the clinical significance of this anatomical variation, particularly in relation to anterior cervical spine surgery.

Main Methods:

  • Computed tomography (CT) angiography was performed on 3460 patients.
  • The course of the prevertebral VA (PVVA) segment and the entry level into the cervical vertebra transverse foramen (CVTF) of the left VA originating from the AA were examined.

Main Results:

  • 153 out of 3460 patients (4.4%) had a left VA originating from the AA.
  • The entry level into the CVTF for these left VAs ranged from C3 to C6.
  • The anatomical course of the PVVA segment showed variations, with most left VAs positioned near the longus colli muscle.

Conclusions:

  • The left VA can originate from the AA, representing a significant anatomical variation.
  • Identifying a long PVVA segment entering a higher CVTF suggests a potential risk during anterior cervical surgery.
  • Performing anterior cervical surgery via a contralateral approach may be safer to avoid VA injury in such cases.
Abstract

Keywords:
AortaClinical significanceLeft vertebral arteryTransverse foramen

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