Left Vertebral Artery Arising Directly From the Arch of the Aorta With a Prevailing Vascular Problem: A Case Report

Aberrant origin of the vertebral artery is a rare case. Due to its important clinical significance during operations in the superior mediastinum and the root of the neck, the variations of this artery should be clarified, and any cadaveric case should be explored specifically if accompanied by any vascular problem. In this cadaveric case, the embalmed male cadaver was found to have a pacemaker wire inserted in the heart through the superior vena cava, denoting a vascular incompetence due to sinus arrhythmia. The left vertebral artery was found to originate from the aortic arch, positioned between the left common carotid artery and the left subclavian artery. It traveled upward behind the left common carotid artery, passing in front of the stellate ganglion and the ventral rami of cervical spinal nerves before entering the left foramen transversarium of the C6 vertebra. This atypical left vertebral artery, which had an unusual origin from the arch of aorta, was distinct from the right vertebral artery, that typically arises from the right subclavian artery. Also, the left atypical artery was found to be narrower and longer than the right one. Additionally, the left common carotid artery exhibited an unusual origin from the beginning of the brachiocephalic trunk. The present case report would be of significance for vascular surgeons in designing surgical intervention in the root of the neck and for clinicians responsible for monitoring patients with variant vertebral arteries to effectively manage potential vascular complications.