Bilateral asymmetrical duplicated origin of vertebral arteries: Multidetector row CT angiographic study

Rameshbabu, CS; Gupta, O. P.; Gupta, Kanchan Kumar; Qasim, Muhammad

doi:10.4103/0971-3026.130699

Cited by 23 publications

(26 citation statements)

References 15 publications

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“…Excluding the cases reported in the 19th century, only 26 cases were reported until 1999 [9]. To the best of our knowledge, nine additional cases have been reported since then (Table 1) [6,8,12,13,[16][17][18][19]. Thus, we consider that 36 cases have been reported (26 cases reviewed by Komiyama and 10 cases reported since 1999, including our case).…”

Section: Discussionmentioning

confidence: 87%

A rare case of dual origin of the left vertebral artery without convergence

et al. 2016

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A case of dual origin of the left vertebral artery was encountered in a dissection course for medical students in 2014. Two vertebral arteries were observed on the left side. One arose from the aortic arch between the origin of the left common carotid artery and the left subclavian artery, entered the transverse foramen of the 4th cervical vertebra, and coursed upward into the transverse foramen. The other arose from the left subclavian artery as expected, divided into two branches anterior to the cervical vertebrae, and entered the transverse foramina of the 6th and 7th cervical vertebrae. Both branches flowed into the anterior spinal artery. Moreover, as seen in other anomalies, 3 arterial fenestrations were observed in the cranial arteries. This case is extremely unique with respect to the following points: the 2 ipsilateral vertebral arteries did not combine to form 1 vertebral artery, the vertebral artery of subclavian artery origin entered the transverse foramen of the 7th cervical vertebra, and 3 fenestrations were observed in the intracranial arteries. This is a very suggestive case for neurosurgeons and radiologists who perform treatments involving the vertebral artery.

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Section: Discussionmentioning

confidence: 87%

A rare case of dual origin of the left vertebral artery without convergence

et al. 2016

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“…All right VAs with proximal right subclavian origin entered C5, C4, or C3; whereas the aberrant right VA entered C7. Moreover, the duplicated segments of left VA fuse at the C5-6 level into a single VA, which then enters the foramen transversarium of C5 [ 3 , 55 , 56 ] .…”

Section: Discussionmentioning

confidence: 99%

“…The mean distance between the brachiocephalic trunk and left common carotid artery was 0.1-0.5 cm and between the left common carotid artery and left subclavian artery was 0.3-2.0 cm [ 69 ] . Some authors tried to depict the anatomy of the dual originated VAs, where the medial limb (3.9 mm in diameter at its origin) originated from its orthodox position, whereas the lateral limb (2.4 mm in diameter at its origin) arose more posteriorly close to the origin of thyrocervical trunk [ 56 ] .…”

Section: Discussionmentioning

confidence: 99%

Aberrant Origin of Vertebral Artery and Its Clinical Implications

Yuan¹

2015

Brazilian Journal of Cardiovascular Surgery

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Aberrant origin of vertebral artery is rare. The anatomical features and clinical significance of this lesion remain to be clarified. A comprehensive collection of the pertinent literature resulted in a cohort of 1286 cases involving 955 patients and 331 cadavers. There were more left than right and more unilateral than bilateral aberrant vertebral arteries. Patients with aberrant origin of vertebral artery were often asymptomatic and in only 5.5% of the patients their symptoms were probably related to the aberrant origin of vertebral artery. The acquired cardiovascular lesions were present in 9.5% of the patients, 20.9% of which were vertebral artery-associated lesions. Eight (0.8%) patients had a vertebral artery dissection. Logistic regression analysis showed significant regressions between bovine trunk and left vertebral artery (P=0.000), between the dual origins of vertebral artery and cerebral infarct/thrombus (P=0.041), between associated alternative congenital vascular variants and cervical/aortic dissection/atherosclerosis (P=0.008). Multiple logistic regression demonstrated that side of the aberrant origin of vertebral artery (left vertebral artery) (P=0.014), arch branch pattern (direct arch origin) (P=0.019), presence of the common trunk (P=0.019), associated acquired vascular disorder (P=0.034) and the patients who warranted management (P=0.000) were significant risk predictors for neurological sequelea. The patients with neurological symptoms and those for neck and chest operations/ interventions should be carefully screened for the possibility of an aberrant origin of vertebral artery. The results from the cadaver metrology study are very helpful in the design of the aortic stent. The arch branch pattern has to be taken into consideration before any maneuver in the local region so as to avoid unexpected events in relation to aberrant vertebral artery.

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“…However, anecdotal reports suggest that this vascular anomaly may be a predisposing factor to VA dissection, intracranial aneurysm, kinking, and arteriovenous malformation (9). Whether the duplicated VA is associated with other pathologic conditions is still matter of debate.…”

Section: Discussionmentioning

confidence: 99%

A Case of Duplicated Origin of the Left Vertebral Artery: CTA and MRA Findings and Literature Review

Lee

Kim

2017

Iran J Radiol

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Duplication of the vertebral artery (VA) is rare but clinically significant. This variant shows a dual origin of VA with fusion at variable levels in the neck. It can be misdiagnosed as a dissection of the VA, arterial hypoplasia, or narrowing on selective catheter angiography. Thorough knowledge of this variation before an endovascular procedure is helpful in preventing unintentional diagnostic or therapeutic challenges. We report a case of a 52-year-old female patient with left duplicated VA, which was incidentally detected by magnetic resonance angiography (MRA) and contrast-enhanced computed tomography angiography (CTA). We have also reviewed the literature and discussed the embryological development of duplicated VA. This report can be helpful in identifying unexpected vascular variations on CTA or MRA and differentiate this anatomical variation from other pathologic conditions in clinical practice such as dissection, arterial hypoplasia, or arterial narrowing.

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Bilateral asymmetrical duplicated origin of vertebral arteries: Multidetector row CT angiographic study

Cited by 23 publications

References 15 publications

A rare case of dual origin of the left vertebral artery without convergence

A rare case of dual origin of the left vertebral artery without convergence

Aberrant Origin of Vertebral Artery and Its Clinical Implications

A Case of Duplicated Origin of the Left Vertebral Artery: CTA and MRA Findings and Literature Review

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