Duplication of the left vertebral artery in a patient with dissection of the right internal carotid artery and Ehlers–Danlos syndrome: case report and review of the literature

Polguj, Michał; Jędrzejewski, Kazimierz; Topol, Mirosław; Wieczorek-Pastusiak, Julia; Majos, Agata

doi:10.1007/s12565-012-0152-z

Cited by 15 publications

(18 citation statements)

References 23 publications

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“…The frequency of duplication of the VA has been identified in 0.72% of cadavers [ 19 ] . Prevertebral duplication may occur when a portion of the primitive dorsal aorta persists along with two intersegmental vessels connected to the true VA [ 61 ] .…”

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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Section: Discussionmentioning

confidence: 99%

Aberrant Origin of Vertebral Artery and Its Clinical Implications

Yuan¹

2015

Brazilian Journal of Cardiovascular Surgery

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“…Moreover visualization of only one trunk of a double VA during catheterization can lead to misdiagnosing the VA as hypoplastic (Kim, 2009). Polguj et al (2013) report that the lumen of the duplicated VA is smaller than normal, hence this variant has clinical implications and should be taken into consideration when the vertebral arteries need catheterization. Therefore, interventional procedures should be performed from the normal side if possible.…”

Section: Duplication Of the Vamentioning

confidence: 99%

Fenestration and duplication of the vertebral artery

et al. 2013

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The vertebral artery (VA) acts as a foundation for the posterior circulation of the head and neck. It presents a number of anomalies that can be easily visualized thanks to modern imaging techniques, such as MR and CT angiography or color Doppler ulrasonography. Determining the appropriate terminology for those anomalies can be sometimes more challenging than their recognition. One particular challenge concerns the differentiation between VA fenestration and duplication. Because of the different clinical prognoses associated with those anomalies, confusion should be avoided. Knowledge of the morphological anomalies associated with the VA is important for both radiologists and head and neck surgeons, because any injury to the VA can result in a threat to the vascular supply of the brain stem, the cerebral or cerebellar hemispheres, the thalamus, cervical nerve roots and particularly the lateral medulla (Wallenberg's syndrome). This article analyses world literature concerning the issue of VA fenestration and duplication to facilitate a differential diagnosis.

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“…The developmental variants of the vertebral artery (VA) mainly include variations in the origin, path, and vascular abnormalities, and they are highly variable, with a variety of manifestations [ 1 ]. VA duplication is very rare, but is occasionally found during digital subtraction angiography (DSA), computed tomography angiography (CTA), magnetic resonance angiography (MRA), or autopsy [ 2 – 4 ]. A better understanding of this variation is important for the diagnosis of cervical vascular disease, as well as cervical and neck vascular intervention surgery.…”

Section: Introductionmentioning

confidence: 99%

Three-Dimensional Time-of-Flight Magnetic Resonance Angiography Detection of Duplication of the Vertebral Artery in a Large Chinese Population

Bai

et al. 2016

Med Sci Monit

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BackgroundThe aim of this study was to investigate duplication of the vertebral artery (VA) using three-dimensional time-of-flight (3D TOF) magnetic resonance angiography (MRA) in a large study population to further our understanding of vascular variations.Material/MethodsA retrospective analysis of 3D TOF-MRA data in 12 826 cases was performed. The occurrence rate of VA duplication was calculated and accompanied vascular anomalies were recoded.ResultsTwenty-one VA duplication patients were found, with an occurrence rate of 0.164%; 12 of them had left VA duplication with 2 branches initially arising from the aortic arch and left subclavian artery; 9 of them were right VA duplication with the branches originating from the right subclavian artery. In the 21 cases, 11 had other vascular abnormalities.ConclusionsVA duplication is very rare and often associated with other vascular abnormalities. 3D TOF-MRA can accurately display the duplication variation. Better understanding of the variation is instrumental for disease diagnosis, interventional therapy, and surgical operation.

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Duplication of the left vertebral artery in a patient with dissection of the right internal carotid artery and Ehlers–Danlos syndrome: case report and review of the literature

Cited by 15 publications

References 23 publications

Aberrant Origin of Vertebral Artery and Its Clinical Implications

Aberrant Origin of Vertebral Artery and Its Clinical Implications

Fenestration and duplication of the vertebral artery

Three-Dimensional Time-of-Flight Magnetic Resonance Angiography Detection of Duplication of the Vertebral Artery in a Large Chinese Population

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