Anatomical Features and Clinical Significance of Radiculomuscular Artery Variants Involving the Suboccipital Segment of Vertebral Artery

Zhu, Shirley; Yang, Yang; Liu, Yuguang; Cao, Jingwei; Li, Feng

doi:10.1007/s00062-016-0520-5

Cited by 12 publications

(6 citation statements)

References 5 publications

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“…The fourth segment is entirely intracranial and terminates when the vertebral arteries join at the lower pontine border to form the basilar artery [9,26]. The VA typically gives off spinal, muscular, meningeal branches, the anterior spinal artery, ramus choroideus ventriculi quarti, medial and lateral medullary branches and the terminal branch, the posterior inferior cerebellar artery (PICA) [62].…”

Section: Introductionmentioning

confidence: 99%

Vertebral artery variations revised: origin, course, branches and embryonic development

et al. 2021

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Background: The vertebral artery originates from the subclavian artery and is divided into four segments. The aim of this study is to investigate the anatomical variations in the course and branches of the vertebral artery. Materials and methods: A research was performed via Pubmed database, using the terms; "variations of vertebral artery AND cadaveric study", "variations of vertebral artery AND cadavers" and "anomalies of vertebral artery AND cadavers". Results: A total of 24 articles met the inclusion criteria, 13 of them referring to variations of the origin of the vertebral artery, 9 to variations of the course and 3 to variations of its branches. On a total sample of 1192 cadavers of different population, origin of the left vertebral artery directly from the aortic arch was observed at 6.7%. In addition, among 311 cadavers, 17.4% were found with partially or fully ossified foramen of the atlas for the passage of the vertebral artery, while the bibliographic review also showed variants at the exit site of the artery from the transverse foramen of the axis. Conclusions: Despite the fact that variations of both the course and the branches of vertebral artery are in most cases asymptomatic, good knowledge of anatomy and its variants is of particular importance for the prevention of vascular complications during surgical and radiological procedures in the cervix area.

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Section: Introductionmentioning

confidence: 99%

Vertebral artery variations revised: origin, course, branches and embryonic development

et al. 2021

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“…Skeletal deformities of the occipito-atlantoaxial complex are usually combined with deformities of vessels, nerves, and muscles (14,15,25). The anomaly rate has been reported to be much higher in people with bone deformities than in those without bone deformities (31), so subjects who had bone deformities were excluded so that we could study the frequency and arrangement of V3 in normal persons.…”

Section: Discussionmentioning

confidence: 99%

“…CTA has been frequently in imaging examinations to simultaneously reveal the three-dimensional anatomy surrounding V3, as it has the advantages of being noninvasive and fast and yielding volumetric scans. Morphometric analyses of V3 performed by using CTA have been reported in many studies (19)(20)(21)(22)(23)(24), but the branches of V3 have been studied in few studies, with small sample sizes of cadavers due to the high cost and intricate procedures required (25)(26)(27). Although a large sample of vertebral arteries can be assessed by CTA, the branches of V3 have not yet been reported.…”

Section: Introductionmentioning

confidence: 99%

The assessment of the frequency and arrangement of the subsegmental branches of V3 using computed tomography angiography

Liu

Song

et al. 2021

Quant Imaging Med Surg

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Background: The frequency and arrangement of the subsegmental branches of the third portion of the vertebral artery (V3) have been assessed in small samples by autopsy, but they have not been assessed by computed tomography angiography (CTA). To determine the frequency and arrangement of subsegmental branches of V3 by CTA and to analyze the interrelationships among frequency, arrangement, sex, and side-to-side.Methods: First, the radiology records of 668 consecutive patients who underwent cervical or craniocervical CTA scans from October 1, 2017 to October 31, 2019 were retrospectively retrieved. Second, the four demarcation points were ascertained to define the three subsegments by reviewing the resource images, namely, the vertical portion of V3(V3v), horizontal portion of V3(V3h), and extradural portion of V3(V3e).Then, the numerical value and the location of the bifurcating branch in each subsegment of V3 were recorded. Third, the frequency and arrangement of the branches was assessed, and the relationships between sex, laterality and frequency and arrangement were analyzed as well as the interobserver performance.Results: On the left, 25%, 20.21%, and 6.59% were the frequencies of one branch in the V3v, V3h, and V3e, and 1.05%, 0.00%, and 0.45% were the frequencies of two branches, respectively. On the right, 25.04%, 17.07%, and 6.44% were the frequencies of one branch in the V3v, V3h, and V3e, and 1.04%, 0.3%, and 0.15% were the frequencies of two branches, respectively. There were no differences between the side-to-side and numerical values of the branches according to the t-test (P=0.4341, P=0.7968), and there were no differences between the side-to-side variable, sex variable and number of branches according to the t-test (P=0.4474, P=0.3593). There were no differences between the side-to-side and eight arrangements (permutation of 000; 100; 110; 111; 010; 011; 001; 101) by using the two-sample KS test (P=0.942), and there were no differences between sex and the eight arrangements according to the two-sample KS test (P=0.9973, P=0.8519). The interobserver reliability was excellent (Spearman's ranked correlation: 0.9927). Conclusions:The frequency and arrangement of V3 subsegmental branches could be displayed by source imaging with CTA, and there were no significant differences according to the sex or side of the individual. It was imperative to acquaint the subsegmental branches before the operation involving V3 in the craniocervical junction to determine the surgical approach and reduce bleeding during the surgical procedures.

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“…At the pontomedullary junction, the right and left VAs converge into the basilar artery [15]. The intracranial segment of VA gives various branches, including the anterior spinal artery, medial and lateral medullary branches, ramus choroideus ventriculi quarti, and posterior inferior cerebellar artery [16].…”

Section: Introductionmentioning

confidence: 99%

Radiological Assessment of Extracranial Vertebral Artery Variations: A Computed Tomography Angiography Study

Al Hajri,

Al Yahya’ey,

Sirasanagandla

et al. 2023

Applied Sciences

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We evaluated the incidence of intraforaminal and extraforaminal variations of the vertebral artery (VA) in the Omani population using computed tomography angiography (CTA). CTA results of 579 consecutive Omani patients (1158 VAs) were reviewed retrospectively for the analysis of unusual entrance transverse foramen (UE-V2), midline migration (MM), persistent first intersegmental artery (PFIA), and paracondylar process (PP) variations of VA. The anomalous origin and VA dominance were also determined. The sex and side differences in the incidence of these variations were analyzed using the Chi-square test. The incidence of UE-V2 was observed in 10.44% (121 out of 1158) of cases. The incidence of UE-V2 at different vertebral levels was observed in the sequence of C5 (71%) > C4 (20.7%) > C7 (7.43%) > C3 (0.8%). The incidence of MM variation was 1.29%. PFIA and PP variations were found in 0.17% and 0.60% of cases, respectively. Left-dominant VA was identified in 44.7% (259 out of 579) of subjects. The incidence of VA variations was not significantly associated with either sex or side. Anomalous VA origin from arch aorta (3.5%) and right common carotid artery (CCA) (0.08%) was identified. The incidence of UE-V2 in Omani subjects is comparatively higher than that reported in other Asian populations. A rare case of VA originating from the right CCA was also identified.

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Anatomical Features and Clinical Significance of Radiculomuscular Artery Variants Involving the Suboccipital Segment of Vertebral Artery

Cited by 12 publications

References 5 publications

Vertebral artery variations revised: origin, course, branches and embryonic development

Vertebral artery variations revised: origin, course, branches and embryonic development

The assessment of the frequency and arrangement of the subsegmental branches of V3 using computed tomography angiography

Radiological Assessment of Extracranial Vertebral Artery Variations: A Computed Tomography Angiography Study

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