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Accessory Vertebral Artery: An Embryological Review With Translation from Adachi
Stephen J Bordes1, Joe Iwanaga2, Sina Zarrintan3
1Department of Anatomical Sciences, St. George's University School of Medicine, St. George's, GRD.
Insights
Accessory vertebral arteries, a rare dual-origin variation, arise during embryonic development. Understanding this anatomy is crucial for head and neck procedures and recognizing cerebrovascular disease risks.
Area of Science:
- Anatomy
- Embryology
- Vascular Surgery
Background:
- The vertebral arteries originate from the subclavian arteries and ascend through cervical vertebrae.
- Developmental variations can lead to accessory vertebral arteries, distinct from duplications or fenestrations.
- Accessory vertebral arteries are rare anatomical variations with dual origins.
Purpose of the Study:
- To review the anatomy and embryology of accessory vertebral arteries.
- To differentiate accessory vertebral arteries from other vascular variations.
- To highlight the clinical significance of accessory vertebral arteries.
Main Methods:
- Review of anatomical and embryological literature.
- Inclusion of historical anatomical descriptions from Buntaro Adachi's work.
- Discussion of clinical implications and associated pathologies.
Main Results:
- Accessory vertebral arteries are defined as ipsilateral vertebral arteries of dual origin.
- Embryological development during weeks 4-6 can lead to their formation.
- Distinction from vertebral artery duplications and fenestrations is clarified.
Conclusions:
- Knowledge of accessory vertebral arteries is vital for head and neck vascular and spinal procedures.
- These variations are linked to cerebrovascular conditions like stroke and dissection.
- Accurate identification is essential for patient safety and management.
Abstract:
The vertebral arteries arise from the posterior superior aspect of the bilateral subclavian arteries and course superiorly through the transverse foramina of C1-C6 vertebrae before joining one another along the anterior surface of the pons. Developmental variations during the fourth to sixth weeks of embryonic development may result in the formation of accessory vertebral arteries, i.e., ipsilateral vertebral arteries of dual origin. This anatomical variation is distinct from and often confused with vertebral artery duplications and fenestrations. This article reviews the anatomy and embryology of the accessory vertebral artery with excerpts from Buntaro Adachi's classic text on vascular anatomical variations. Knowledge of accessory vertebral vessels is important during vascular and spinal procedures of the head and neck. Furthermore, these variations have been associated with cerebrovascular pathologies, such as stroke, dissection, and other hemodynamic anomalies.