Evaluation of vertebral artery dominance, hypoplasia and variations in the origin: angiographic study in 254 patients

Ergün, Onur; Tatar, İdil Güneş; Birgi, Erdem; Hekįmoğlu, Baki

doi:10.5603/fm.a2015.0061

Cited by 24 publications

(30 citation statements)

References 13 publications

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“…Our study only included anterior circulation ischemic occlusions and excluded posterior circulation ischemic occlusions for efficacy of the BGC. Mean diameter of the vertebral artery is 3.2 mm, which is insufficient to advance a BGC catheter (mean external diameter of distal tip, 2.55 mm)7). If the BCG passes the proximal unilateral vertebral artery, contralateral flow remains in the vertebral artery.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of Balloon-Guiding Catheter for Mechanical Thrombectomy in Patients with Anterior Circulation Ischemic Stroke

Yoon

Shim

et al. 2017

J Korean Neurosurg Soc

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ObjectiveTo evaluate the efficacy of balloon guiding catheter (BGC) during thrombectomy in anterior circulation ischemic stroke.MethodsSixty-two patients with acute anterior circulation ischemic stroke were treated with thrombectomy using a Solitaire stent from 2011 to 2016. Patients were divided into the BGC group (n=24, 39%) and the non-BGC group (n=38, 61%). The number of retrievals, procedure time, thrombolysis in cerebral infarction (TICI) grade, presence of distal emboli, and clinical outcomes at 3 months were evaluated.ResultsSuccessful recanalization was more frequent in BGC than in non-BGC (83% vs. 66%, p=0.13). Distal emboli occurred less in BGC than in non-BGC (23.1% vs. 57.1%, p=0.02). Good clinical outcome was more frequent in BGC than in non-BGC (50% vs. 16%, p=0.03). The multivariate analysis showed that use of BGC was the only independent predictor of good clinical outcome (odds ratio, 5.19: 95% confidence interval, 1.07–25.11). More patients in BGC were successfully recanalized in internal carotid artery (ICA) occlusion with small retrieval numbers (<3) than those in non-BGC (70% vs. 24%, p=0.005). In successfully recanalized ICA occlusion, distal emboli did not occur in BGC, whereas nine patients had distal emboli in non-BGC (0% vs. 75%, p=0.001) and good clinical outcome was superior in BGC than in non-BGC (55.6% vs. 8.3%, p=0.01).ConclusionA BGC significantly reduces the number of retrievals and the occurrence of distal emboli, thereby resulting in better clinical outcomes in patients with anterior circulation ischemic stroke, particularly with ICA occlusion.

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Section: Discussionmentioning

confidence: 99%

Efficacy of Balloon-Guiding Catheter for Mechanical Thrombectomy in Patients with Anterior Circulation Ischemic Stroke

Yoon

Shim

et al. 2017

J Korean Neurosurg Soc

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“…In addition, the incidence of posterior circulation infarctions is higher in VAD patients, especially in the posterior inferior cerebellar and basilar artery territories [48]. However, there is no consensus among researchers and clinicians over the exact definitions of VAD and VAH [7]. Discordance also exists in the literature regarding which side is dominant in several populations.…”

Section: Introductionmentioning

confidence: 99%

“…Discordance also exists in the literature regarding which side is dominant in several populations. Some researchers have reported left vertebral dominance [35,51], others right [1,7] whilst others reported no difference at all [29]. Previously, VAH was defined as a VA diameter < 2.5 mm [11] and VAD was defined as the side to side diameter difference ≥ 0.3 mm [14].…”

Section: Introductionmentioning

confidence: 99%

The applied anatomy and clinical significance of the proximal, V1 segment of vertebral artery

Guan

Zilundu

et al. 2019

Folia Morphol

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Background: The aim of the study was to probe the morphological features of the proximal segment (V1) of vertebral artery (VA) in a sample of Chinese cadavers. Materials and methods: The origin, course and outer diameter at origin of the pre-vertebral part of the VAs were evaluated in 119 adult cadavers. Results: It was found that 94.12% of the VAs originated from the subclavian arteries, bilaterally. The variant origins were present in 5.88% of the cadavers and all originated directly from the arch of the aorta. All the variations were observed on the left side of male cadavers. The average outer diameters at origin of the normal and variation groups were 4.35 ± 1.00 mm and 4.82 ± ± 1.42 mm, respectively, p = 0.035. In the normal group, but not in the variation group, the average diameter in the males was significantly larger than that in the females (4.50 ± 0.99 mm, 3.92 ± 0.92 mm, respectively, p = 0.000). In addition, only 5 cadavers in the normal group had hypoplastic VAs (4.20%, 4 males,. Vertebral artery dominance (VAD) was present in 91 (69 males) out of 112 cadavers and more common on the left (n = 48). In addition, 3 cadavers satisfied conditions for coexistence of VAD and vertebral artery hypoplasia. All 7 cadavers in the variation group exhibited VAD, which was more common on the right side (n = 5). Conclusions: The morphologic variations and frequencies described above have implications for the early prevention, abnormal anatomy detection, accurate diagnosis, safe surgery and endovascular treatment of cardiovascular and neurological disease. (Folia Morphol 2019; 78, 4: 710-719)

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“…The VAs are associated with a number of anatomical variations. For example, in approximately 4-6% of subjects the left VA arises from the aortic arch [5,11]. Additionally, in nearly 60-70% of subjects, the VAs are of unequal size, with the left more commonly larger than the right [6,13,15].…”

Section: Discussionmentioning

confidence: 99%

“…The majority of such variation is related to origin of this vessel (e.g. from aortic arch or thyrocervical trunk [5]). Absence of the VA appears to be a rare anomaly [1], but may be more common in individuals with cranio-vertebral anomalies [17].…”

Section: Introductionmentioning

confidence: 99%

A case of a single intracranial vertebral artery and cerebral infarct

Blackburn

Labranche²,

Kalmey

et al. 2017

Folia Morphol

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Evaluation of vertebral artery dominance, hypoplasia and variations in the origin: angiographic study in 254 patients

Abstract: Background: The aim of this study was to determine the dimensional characteristics and variations in the origin of vertebral arteries (VA). Materials and methods: (Folia Morphol 2016; 75, 1: 33-37)

Cited by 24 publications

References 13 publications

Efficacy of Balloon-Guiding Catheter for Mechanical Thrombectomy in Patients with Anterior Circulation Ischemic Stroke

Efficacy of Balloon-Guiding Catheter for Mechanical Thrombectomy in Patients with Anterior Circulation Ischemic Stroke

The applied anatomy and clinical significance of the proximal, V1 segment of vertebral artery

A case of a single intracranial vertebral artery and cerebral infarct

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