Morphometric study for the intracranial portion of the vertebral artery in human cadavers

Patel, Zeel; Abdulrahman, Ali Abdulsattar

doi:10.1016/j.tria.2020.100076

Cited by 5 publications

(3 citation statements)

References 7 publications

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“…The first three segments were extracranial and the fourth segment is entirely intracranial and terminates with forming the basilar artery (BA). It is the fourth segment of VA that gives off the PICA, which is the largest branch of VA 3 - 5 . The trunk of PICA is divided into five segments (Figure 1 ): (1) the anterior medullary segment, which begins at the origin of the PICA and ends at the level of a rostrocaudal line that passing through the most prominent part of the inferior olive; (2) the lateral medullary segment, which extends from the level of the most prominent point of the olive to the level of the origin of the glossopharyngeal (CN Ⅸ), vagus (CN Ⅹ), and accessory (CN Ⅺ) rootlets; (3) the tonsillomedullary segment, which begins where the PICA passes posterior to the CN IX-XI and ends at the midpoint of the PICA's ascent toward the roof of the fourth ventricle along the medial surface of the tonsil; (4) the telovelotonsillar segment, which begins where the PICA ascends to the mid-level of the medial surface of the tonsil and ends where the artery exits the fissures between the tonsil, vermis, and hemisphere to reach the suboccipital surface; (5) the cortical segment, this segment begins where the PICA leaves the groove between the vermis, tonsil and hemisphere, and includes the terminal cortical branches 1 , 6 .…”

Section: Introductionmentioning

confidence: 99%

“…The incidence of PICA fenestration is reported to be 0.3% 18 . Some investigators hold the view that variations such as duplications and fenestrations were prone to the coexistence of vascular anomalies including aneurysms, vascular malformations, dissections due to the abnormal vascular structure and hemodynamics 5 .The VA terminating in the PICA is reported in 2.8 - 7% patients, which is also one of the most common variations of VA 3 , 18 - 20 . This variation may have a detrimental impact on cerebral hemodynamics 21 .…”

Section: Introductionmentioning

confidence: 99%

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Clinical Importance of the Posterior Inferior Cerebellar Artery: A Review of the Literature

Miao¹,

Zhang²,

Wang³

et al. 2020

Int. J. Med. Sci.

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The posterior inferior cerebellar artery (PICA), with its unique anatomical complexity, is of great clinical importance and involved in many diseases including aneurysm, ischemic stroke, neurovascular compression syndrome (NVCS), arteriovenous malformation (AVM), and brain tumor. However, a comprehensive systematic review of the importance of the PICA is currently lacking. In this study, we perform a literature review of PICA by searching all the associated papers in the PUBMED database hoping to provide a better understanding of the artery. The PICA has tortuous and variable course and territory, divided into 5 segments. Various aneurysms involving PICA were not uncommon, of which the treatment is challenging. The PICA infarct typically manifests lateral medullary syndrome (LMS) and is more likely to cause mass effects. The PICA frequently compresses the medulla and the cranial nerves resulting in various neurovascular compression syndromes (NVCS). Arteriovenous malformation (AVM) fed by PICA are associated with aneurysm and dissection which have high risk of rupture and worse outcome. PICA injured by head trauma can cause fatal SAH. VA terminating in PICA probably cause Bow hunter's syndrome (BHS). The PICA supplies many brain tumors and can be used in intracerebellar chemotherapy. The PICA can be exposed and injured during surgeries especially in telovelar approach, and it also plays an important role in bypass surgeries, hinting the surgical importance of PICA. In conclusion, PICA is very important in clinical practice.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Clinical Importance of the Posterior Inferior Cerebellar Artery: A Review of the Literature

Miao¹,

Zhang²,

Wang³

et al. 2020

Int. J. Med. Sci.

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show abstract

“…The main blood supply to the spinal cord originates from the vertebral, segmental, and hypogastric arteries. The vertebral artery may be anatomically complete, partially duplicated, or asymmetric due to unilateral hypoplasia, or it may terminate in the posterior inferior cerebellar artery (PICA) [ 6 ] . The prevalence of PICA variation is about 4-5% [ 7 ] .…”

Section: Discussionmentioning

confidence: 99%

Mid-Term Results of Left Carotid-Subclavian Bypass in Patients Undergoing Zone 2 TEVAR

İnce

Altinay

Huseynov

et al. 2022

Braz J Cardiovasc Surg

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Introduction The aim of this study was to present the mid-term results of patients who had undergone a carotid-subclavian bypass surgery after a thoracic endovascular aortic repair (TEVAR) stent-graft implantation with proximal landing at zone 2 of the aorta. Methods A total of 66 patients had undergone TEVAR and carotid-subclavian bypass between January 2015 and May 2020 at our clinic. Five of these patients were lost to follow-up, so 61 patients were included in this retrospective study. At follow-up visits, patency of the carotid-subclavian bypass grafts was evaluated with physical examination and radiological imaging. Results The mean follow-up time was 15.11±12.29 months (ranging from 1 to 56 months). There were 3 (4.91%) in-hospital deaths of patients admitted with bilateral lower limb and visceral malperfusion. There were also 2 (3.27%) deaths unrelated to the procedure. Carotid-subclavian graft occlusion occurred in 3 (4.91%) patients. The occlusion was detected with radiological imaging within a period of 12 to 24 months. The graft patency rate was 100% in the first 12 months. The mean graft patency time (survival) was 52.56±2.10 months. Conclusion Periprocedural carotid-subclavian bypass surgery with synthetic grafts is a recommended procedure with high patency and acceptably low mortality and morbidity rates in TEVAR.

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An Exploratory Morphometric Study of the Atlantal Part of Vertebral Artery

Punja,

Kausar,

et al. 2023

Preprint

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Purpose: The vertebral artery (VA) is a major artery in the neck region. It arises from the first segment of the subclavian artery. The artery then traverses through the transverse foramina of each cervical vertebra leaving the transverse foramina of seventh cervical vertebrae. At the level of lower border of pons, the VA from opposite sides unite its fellow artery to form the basilar artery. There are a quite good number of CT studies of this region, whereas there are limited cadaveric studies of this region. Thus, this study aims to fill up the research gap, by doing morphometric cadaveric study of V3 segmental VA in reference to length diameter and length. And Angle of the vertical and horizontal part of V3 (Atlantal) segment of vertebral artery Methods: The study was conducted in the 40 vertebral arteries from 20 embalmed cadavers . Results: The mean length of right and left VA on each part was almost similar except for the mean length of H part (R- 38.937mm & L-40.237mm) and total length of V3 segment (R- 66.87mm & L-70.350mm). Conclusion: This will be of great importance to neurosurgeons who intend to operate a limited part (any of the 3 parts) of V3 segment of VA. The mean values of parameters resulted in this study gives an average measurements or safe limits to the surgeons for the safe surgical procedures like occipital condyle screw technique

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Morphometric study for the intracranial portion of the vertebral artery in human cadavers

Cited by 5 publications

References 7 publications

Clinical Importance of the Posterior Inferior Cerebellar Artery: A Review of the Literature

Clinical Importance of the Posterior Inferior Cerebellar Artery: A Review of the Literature

Mid-Term Results of Left Carotid-Subclavian Bypass in Patients Undergoing Zone 2 TEVAR

An Exploratory Morphometric Study of the Atlantal Part of Vertebral Artery

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