Surgical and Radiologic Anatomy

, Volume 40, Issue 7, pp 779–797 | Cite as

A systematic classification of the vertebral artery variable origin: clinical and surgical implications

  • Nikolaos Lazaridis
  • Maria Piagkou
  • Marios Loukas
  • Evangelia-Theophano Piperaki
  • Trifon Totlis
  • Georgios Noussios
  • Konstantinos Natsis


Several congenital anomalies regarding the right (RVA) and left (LVA) vertebral artery have been described. The current paper aims to perform a systematic literature review of the variable vertebral artery (VA) origin from the aortic arch (AOA) and its branches. The incidence of these variants and the ensuing AOA branching pattern are highlighted. Atypical origin cases were found more commonly unilaterally, while LVA presented the majority of the aberrancies. The LVA emersion from the AOA (3.6%) and the RVA from the right common carotid artery (RCCA) (0.14%) were the commonest origin variations. Aberrant RVA origin as last branch of the AOA is very rare. Eighteen cases (0.12%) with an aberrant right subclavian artery (ARSCA) were found. Among them, the RVA originated from the RCCA and right subclavian artery in 94.4 and 5.6%, respectively. Sporadic cases had an AOA origin bilaterally; RVA and LVA had a double origin in 0.027 and 0.11%, respectively. A dual origin was detected in 0.0069%, bilaterally. The atypical VA origin may coexist with: (i) an ARSCA, (ii) a common origin of brachiocephalic artery and left common carotid artery (the misnomer bovine arch) and (iii) a bicarotid trunk. The aberrant VA origin favors hemodynamic alterations, predisposing to cerebrovascular disorders and intracranial aneurysm formation. Detailed information of VA variants is crucial for both endovascular interventionists and diagnostic radiologists involved in the treatment of patients with cerebrovascular disease. Such information may prove useful to minimize the risk of VA injury in several procedures.


Aortic arch Classification Origin, subclavian artery, vertebral artery Variations 


  1. 1.
    Adachi B (1928) Das arteriensystem der Japaner. Kaiserlich-Japanischen Universitate zu Kyoto, KyotoGoogle Scholar
  2. 2.
    Akdeniz B, Yilmaz E, Pekel N, Ergul BU (2007) Anomalous origin of the right vertebral artery from the ascending aorta in the presence of aberrant right subclavian artery. Int J Cardiovasc Imaging 23:39–42CrossRefPubMedGoogle Scholar
  3. 3.
    Albayram S, Gailloud P, Wasserman BA (2002) Bilateral arch origin of the vertebral arteries. Am J Neuroradiol 23:455–458PubMedGoogle Scholar
  4. 4.
    Al-Okaili R, Schwartz ED (2007) Bilateral aortic origins of the vertebral arteries with right vertebral artery arising distal to left subclavian artery: case report. Surg Neurol 67:174–176CrossRefPubMedGoogle Scholar
  5. 5.
    Argenson C, Francke J, Sylla A et al (1980) The vertebral arteries. Anat Clin 2:29–32CrossRefGoogle Scholar
  6. 6.
    Baik J, Baek HJ, Shin HS, Choi KH (2016) Duplication of the right vertebral artery: MRA findings and review of the literature. Spingerplus 5:1123. CrossRefGoogle Scholar
  7. 7.
    Bergman RA, AWW AK, Miyauchi R (1985–2002) Illustrated encyclopedia of human anatomic variation (online), pp 1–38, 330.
  8. 8.
    Bernardi L, Dettori P (1975) Angiographic study of a rare anomalous origin of the vertebral artery. Neuroradiology 9:43–47CrossRefGoogle Scholar
  9. 9.
    Bhatia K, Ghabriel MN, Henneberg M (2005) Anatomical variations in the branches of the human aortic arch: a recent study of a South Australian population. Folia Morphol 64:217–223Google Scholar
  10. 10.
    Budhiraja V, Rastogi R, Jain V, Bankwar V, Raghuwanshi S (2013) Anatomical variations in the branching pattern of human aortic arch: a cadaveric study from central India. ISRN Anat 2013:828969. PubMedPubMedCentralCrossRefGoogle Scholar
  11. 11.
    Cavdar S, Arisan E (1989) Variations in the extracranial origin of the human vertebral artery. Acta Anat (Basel) 135:236–238CrossRefGoogle Scholar
  12. 12.
    Celikyay ZR, Koner AE, Celikyay F, Denız C, Acu B (2013) Frequency and imaging findings of variations in human aortic arch anatomy based on multidetector computed tomography data. Clin Imaging 37:1011–1019CrossRefPubMedGoogle Scholar
  13. 13.
    Cohen JE, Grigoriadis S, Itshayek E (2011) Type ΙΙ proatlantal artery (occipital subtype) with bilateral absence of the vertebral arteries. Clin Anat 24:950–952CrossRefPubMedGoogle Scholar
  14. 14.
    Daseler EH, Anson BJ (1959) Surgical anatomy of the subclavian artery and its branches. Surg Gynecol Obstet 108:149–74Google Scholar
  15. 15.
    De Garis CF, Black IH, Riemenschneider EA (1933) Patterns of the aortic arch in American White and Negro stocks with comparative notes on certain other mammals. J Anat 67:599–619PubMedPubMedCentralGoogle Scholar
  16. 16.
    Dudich K, Bhadelia R, Srinivasan J (2005) Anomalous vertebral artery origin may be an independent risk factor for arterial dissection. Eur J Neurol 12:571–572CrossRefPubMedGoogle Scholar
  17. 17.
    Dumfarth J, Chou AS, Ziganshin BA, Bhandari R, Peterss S, Tranquilli M, Mojibian H, Fang H, Rizzo JA, Elefteriades JA (2015) Atypical aortic arch branching variants: a novel marker for thoracic aortic disease. J Thorac Cardiovasc Surg 149:1586–1592CrossRefPubMedGoogle Scholar
  18. 18.
    Eisenberg R, Vines F, Taylor S (1986) Bifid origin of the left vertebral artery. Radiology 159:429–430CrossRefPubMedGoogle Scholar
  19. 19.
    Elumalai G, Chodisetty S (2016) The true silent killers bovine and truncus bicaroticus aortic arches in embryological basis and surgical implications. Elixir Physio Anat 97:42246–42252Google Scholar
  20. 20.
    Flynn RE (1968) External carotid origin of the dominant vertebral artery: case report. J Neurosurg 29:300–301CrossRefPubMedGoogle Scholar
  21. 21.
    Gailloud P, Gregg L, Pearl MS, San Millan D (2017) Ascending and descending thoracic vertebral arteries. AJNR Am J Neuroradiol 38:327–335CrossRefPubMedGoogle Scholar
  22. 22.
    Gluncic V, Ivikic G, Marin D, Percac S (1999) Anomalous origin of both vertebral arteries. Clin Anat 12:281–284CrossRefPubMedGoogle Scholar
  23. 23.
    Goray VB, Joshi AR, Gary A, Merchant S, Yadav B, Maheshwari P (2005) Aortic arch variations: a unique case with anomalous origin of both vertebral arteries as additional branches of aortic arch distal to the left sub-clavian artery. Am J Neuroradiol 26:93–5Google Scholar
  24. 24.
    Gordon Perue GL, Narayan R, Zangiabadi AH, Romano JG, Rundek T, Sacco RL, Koch S (2015) Prevalence of vertebral artery origin stenosis in a multirace-ethnic posterior circulation stroke cohort: Miami Stroke Registry (MIAMISR). Int J Stroke 10:185–187. CrossRefPubMedGoogle Scholar
  25. 25.
    Himabindu A, Rao BN (2012) A study on variant origins of vertebral artery. Int J Basic Appl Med Sci 2:34–37Google Scholar
  26. 26.
    Ikegami A, Ohtani Y, Ohtani O (2007) Bilateral variations of the vertebral arteries: the left originating from the aortic arch and the left and right entering the C5 transverse foramina. Anat Sci Int 82:175–179CrossRefPubMedGoogle Scholar
  27. 27.
    Ionete C, Omojola MF (2006) MR angiographic demonstration of bilateral duplication of the extracranial vertebral artery: unusual course and review of the literature. Am J Neuroradiol 27:1304–1306PubMedGoogle Scholar
  28. 28.
    Ishihara H, San Millán Ruíz D, Abdo G, Asakura F, Yilmaz H, Lovblad KO, Rüfenacht DA (2011) Combination of rare right arterial variation with anomalous origins of the vertebral artery, aberrant subclavian artery and persistent trigeminal artery. A case report. Interv Neuroradiol 17:339–342CrossRefPubMedPubMedCentralGoogle Scholar
  29. 29.
    Iyer A (1927) Some anomalies of the origin of the vertebral artery. J Anat 62:121–122PubMedPubMedCentralGoogle Scholar
  30. 30.
    Jenkins JS, Patel SN, White CJ, Collins TJ, Reilly JP, McMullan PW, Grise MA, Grant AG, Ramee SR (2010) Endovascular stenting for vertebral artery stenosis. J Am Coll Cardiol 55:538–542CrossRefPubMedGoogle Scholar
  31. 31.
    Jiang S, Sun XW, Jie B, Yu D (2014) Endovascular embolization of an aberrant bronchial artery originating from the vertebral artery in a patient with massive hemoptysis. Cardiovasc Intervent Radiol 37:1099. CrossRefPubMedGoogle Scholar
  32. 32.
    Karacan A, Türkvatan A, Karacan K (2014) Anatomical variations of aortic arch branching: evaluation with computed tomographic angiography. Cardiol Young 24:485–493CrossRefPubMedGoogle Scholar
  33. 33.
    Karcaaltincaba M, Strottman J, Washington L (2003) Multidetector-row CT angiographic findings in the bilateral aortic arch origin of the vertebral arteries. AJNR Am J Neuroradiol 24:157PubMedGoogle Scholar
  34. 34.
    Kaufmann TJ, Huston J III, Mandrekar JN, Schleck CD, Thielen KR, Kallmes DF (2007) Complications of diagnostic cerebral angiography: evaluation of 19 826 consecutive patients. Radiology 243:812–819CrossRefPubMedGoogle Scholar
  35. 35.
    Kawate T, Futamata H, Kitami Y, Takeda S (2008) Rare multiple combined anomaly of the vertebral vessels and bronchial artery. Anat Sci Int 83:267–272. CrossRefGoogle Scholar
  36. 36.
    Kemmetmüller H (1911) über eine seltene Varietat der Art. vertebralis. Anat Hefte 44:305–362CrossRefGoogle Scholar
  37. 37.
    Kim SR, Baik MW, Yoo SH, Park IS, Kim SD, Kim MC (2007) Stent fracture and restenosis after placement of a drug-eluting device in the vertebral artery origin and treatment with the stent-in-stent technique. Report of two cases. J Neurosurg 106:907–911CrossRefPubMedGoogle Scholar
  38. 38.
    Kiss J (1968) Bifid origin of the right vertebral artery: a case report. Radiology 91:931CrossRefPubMedGoogle Scholar
  39. 39.
    Komiyama M, Morikawa T, Nakajima H, Nishikawa M, Yasui T (2001) High incidence of arterial dissection associated with left vertebral artery of aortic origin. Neurol Med Chir (Tokyo) 41:8–12CrossRefGoogle Scholar
  40. 40.
    Komiyama M, Nakajima H, Yamanaka K, Iwai Y (1999) Dual origin of the vertebral artery. Neurol Med Chir 39:932–937CrossRefGoogle Scholar
  41. 41.
    Lacout A, Khalil A, Figl A, Liloku R, Marcy PY (2012) Vertebral arteria lusoria: a life-threatening condition for oesophageal surgery. Surg Radiol Anat 34:381–383CrossRefPubMedGoogle Scholar
  42. 42.
    Lale P, Toprak U, Yagız G, Kaya T, Uyanık SA (2014) Variations in the branching pattern of the aortic arch detected with computerized tomography angiography. Adv Radiol 2014:1–6. (Article ID 969728) CrossRefGoogle Scholar
  43. 43.
    Layton KF, Kallmes DF, Cloft HJ, Lindell EP, Cox VS (2006) Bovine aortic arch variant in humans: clarification of a common misnomer. AJNR Am J Neuroradiol 27:1541–1542PubMedGoogle Scholar
  44. 44.
    Lemke AJ, Benndorf G, Liebig T, Felix R (1999) Anomalous origin of the right vertebral artery: review of the literature and case report of right vertebral artery origin distal to the left subclavian artery. Am J Neuroradiol 20:1318–1321PubMedGoogle Scholar
  45. 45.
    Li S, Li Y, Bai M, Zhang C (2016) Three-dimensional time-of-flight magnetic resonance angiography detection of duplication of the vertebral artery in a large chinese population. Med Sci Monit 22:3771–3777CrossRefPubMedPubMedCentralGoogle Scholar
  46. 46.
    Liechty JD, Shields TW, Anson BJ (1957) Variations pertaining to the aortic arches and their branches. Q Bull Northwest Univ Med Sch 31:136–143PubMedPubMedCentralGoogle Scholar
  47. 47.
    Liu Y, Hua Y, Liu B, Jia L, Jiao L (2014) Anomalous origin of bilateral vertebral arteries from the ICA: review of the literature and a case report. Ann Vasc Surg 28:1319.e13-6. PubMedCrossRefGoogle Scholar
  48. 48.
    Loukas M, Louis RG Jr, Gaspard J, Fudalej M, Tubbs RS, Merbs W (2006) A retrotracheal right subclavian artery in association with a vertebral artery and thyroideaima. Folia Morphol (Warsz) 65:236–241Google Scholar
  49. 49.
    Lui CC, Liu YH, Wai YY, Tsai CC (1987) Persistence of both proatlantal arteries with absence of vertebral arteries. Neuroradiology 29:304–305CrossRefPubMedGoogle Scholar
  50. 50.
    Mahmutyazicioğlu K, Sarac K, Boluk A, Kutlu R (1998) Duplicate origin of left vertebral artery with thrombosis at the origin: color Doppler sonography and CT angiography findings. J Clin Ultrasound 26:323–325CrossRefPubMedGoogle Scholar
  51. 51.
    Matula C, Tratting S, Tschabitscher M, Day JD, Koos WT (1997) The course of the prevertebral segment of the vertebral artery: anatomy and clinical significance. Surg Neurol 48:125–131CrossRefGoogle Scholar
  52. 52.
    McDonald JJ, Anson BJ (1940) Variations in the origin of arteries derived from the aortic arch, in American whites and negroes. Am J Phys Anthropol 27:91–107CrossRefGoogle Scholar
  53. 53.
    Meila D, Tysiac M, Petersen M, Theisen O, Wetter A, Mangold A, Schlunz-Hendann M, Papke K, Brassel F, Berenstein A (2012) Origin and course of the extracranial vertebral artery: CTA findings and embryologic considerations. Clin Neuroradiol 22:327–333CrossRefPubMedGoogle Scholar
  54. 54.
    Mohammadian R, Najaran A, Sohrabi B, Mansourizadeh R, Mohammadian F, Nasiri B, Farhoudi M (2011) Vertebral artery orifice stenosis: a report of 43 cases from northwest iran treated with angioplasty and stenting. Neuroradiol J 24:749–757CrossRefGoogle Scholar
  55. 55.
    Mukkannavar SB, Kuthe SA, Mishra AK, Rohit MK (2013) Aberrant right vertebral artery from descending thoracic aorta. Ann Thorac Surg 96:1074–1076CrossRefPubMedGoogle Scholar
  56. 56.
    Nasir S, Hussain M, Khan SA, Mansoor MA, Sharif S (2010) Anomalous origin of right vertebral artery from right external carotid artery. J Coll Physicians Surg Pak 20:208–210PubMedGoogle Scholar
  57. 57.
    Natsis K, Didagelos M, Gkiouliava A, Lazaridis N, Vyzas V, Piagkou M (2016) The aberrant right subclavian artery: cadaveric study and literature review. Surg Radiol Anat. (Epub ahead of print) CrossRefPubMedGoogle Scholar
  58. 58.
    Natsis KI, Tsitouridis IA, Didagelos MV, Fillipidis AA, Vlasis KG, Tsikaras PD (2009) Anatomical variations in the branches of the human aortic arch in 633 angiographies: clinical significance and literature review. Surg Radiol Anat 31:319–23CrossRefGoogle Scholar
  59. 59.
    Nayak SR, Pai MM, Prabhu LV, D’Costa S, Shetty P (2006) Anatomical organization of aortic arch variations in the India: embryological basis and review. J Vasc Bras 5:95–100CrossRefGoogle Scholar
  60. 60.
    Nelson ML, Sparks CD (2001) Unusual aortic arch variation: distal origin of common carotid arteries. Clin Anat 14:62–65CrossRefPubMedGoogle Scholar
  61. 61.
    Nizankowski C, Rajchel Z, Ziolkowksi M (1975) Abnormal origin of arteries from the aortic arch in man. Folia Morphol (Warsz) 34:109–116Google Scholar
  62. 62.
    Nogueira TE, Chambers AA, Brueggemeyer MT, Miller TJ (1997) Dual origin of the vertebral artery mimicking dissection. Am J Neuroradiol 18:382–384PubMedGoogle Scholar
  63. 63.
    Ohkura K, Shiiya N, Washiyama N, Yamashita K, Takahashi D, Tsuda K, Kando Y (2014) Vertebral artery variations in thoracic aortic patients. Eur J Cardiothorac Surg 46:27–31CrossRefPubMedGoogle Scholar
  64. 64.
    Öner Z, Öner S, Kahraman AS (2017) The right vertebral artery originating from the right occipital artery and the absence of the transverse foramen: a rare anatomical variation. Surg Radiol Anat. (Epub ahead of print) PubMedCrossRefGoogle Scholar
  65. 65.
    Patil PV, Patil AM, Apte AV, Attarde VY (2015) Anomalous origin of left vertebral artery from carotid bulb seen as “trifurcation” of left common carotid artery with acute infarct in ipsilateral thalamus: a case report. J Neuroimaging 25:662–664CrossRefPubMedGoogle Scholar
  66. 66.
    Polguj M, Podgórski M, Jędrzejewski K, Topol M, Majos A (2013) Fenestration and duplication of the vertebral artery: the anatomical and clinical points of view. Clin Anat 26:933–943CrossRefPubMedGoogle Scholar
  67. 67.
    Poonam SRK, Sharma T (2010) Incident of the anomalous origins of the vertebral artery—anatomical study and clinical significance. JCDR 4:2626–2631Google Scholar
  68. 68.
    Quain R (1844) The anatomy of the arteries of the human body. Taylor and Walton, London, pp 153–156Google Scholar
  69. 69.
    Rameshbabu C, Gupta OP, Gupta KK, Qasim M (2014) Bilateral asymmetrical duplicated origin of vertebral arteries: multidetector row CT angiographic study. Indian J Radiol Imaging 24:61–65CrossRefPubMedPubMedCentralGoogle Scholar
  70. 70.
    Rath G, Prakash R (1984) Double vertebral artery in an Indian cadaver. Clin Anat 6:117–119CrossRefGoogle Scholar
  71. 71.
    Rathore MH, Sreenivasan VV (1989) Vertebral and right subclavian artery abnormalities in the Down syndrome. Am J Cardiol 63:1528–1529CrossRefPubMedGoogle Scholar
  72. 72.
    Rieger P, Huber G (1983) Fenestration and duplicate origin of the left vertebral artery in angiography. Report of three cases. Neuroradiology 25:45–50CrossRefPubMedGoogle Scholar
  73. 73.
    Samaniego EA, Linfante I, Dabus G (2012) Techniques for the diagnosis of vertebral artery origin stenosis and considerations for determining treatment and timing. Interv Cardiol 4:419–427CrossRefGoogle Scholar
  74. 74.
    Satti SR, Cerniglia CA, Koenigsberg RA (2007) Cervical vertebral artery variations: an anatomic study. AJNR Am J Neuroradiol 28:976–980Google Scholar
  75. 75.
    Sharma A, Kumar S, Sharma S (2017) Vertebral artery from descending thoracic aorta: rare anatomic variant with diagnostic implication. Acta Neurochir (Wien) 159:1105–1106. (Epub 2017 Apr 8) CrossRefGoogle Scholar
  76. 76.
    Shiva Kumar GL, Pamidi N, Somayaji SN, Nayak S, Vollala VR (2010) Anomalous branching pattern of the aortic arch and its clinical applications. Singap Med J 51:182–183Google Scholar
  77. 77.
    Sikka A, Jain A (2012) Bilateral variation in the origin and course of the vertebral artery. Anat Res Int 2012:580765. (Epub 2012 Jun 6)PubMedPubMedCentralCrossRefGoogle Scholar
  78. 78.
    Stoesslein F, Porstmann W, Schueler F, Schoepke W (1982) Aberrant vertebral artery originating from the descending aorta: a new congenital steal syndrome in coarctation. Eur J Radiol 2:157–159PubMedGoogle Scholar
  79. 79.
    Takafuji T, Sato Y (1991) Study on the subclavian artery and its branches in Japanese adults. Okajimas Folia Anat Jpn 68:171–186CrossRefPubMedGoogle Scholar
  80. 80.
    Takasato Y, Hayashi H, Kobayashi T, Hashimoto Y (1992) Duplicated origin of right vertebral artery with rudimentary and accessory left vertebral arteries. Neuroradiology 34:287–289CrossRefPubMedGoogle Scholar
  81. 81.
    Tardieu GG, Edwards B, Alonso F, Watanabe K, Saga T, Nakamura M, Motomura M, Sampath R, Iwanaga J, Goren O, Monteith S, Oskouian RJ, Loukas M, Tubbs RS (2017) Aortic arch origin of the left vertebral artery: an anatomical and radiological study with significance for avoiding complications with anterior approaches to the cervical spine. Clin Anat. (Epub ahead of print)PubMedCrossRefGoogle Scholar
  82. 82.
    Thomas AJ, Germanwala AV, Vora N, Prevedello DM, Jovin T, Kassam A, Horowitz M (2008) Dual origin extracranial vertebral artery: case report and embryology. J Neuroimaging 18:173–176CrossRefPubMedGoogle Scholar
  83. 83.
    Thompson A (1893) Nine variations in mode of origin of branches of aortic arch. J Anat Physiol 27:183–194Google Scholar
  84. 84.
    Tsai IC, Tzeng WS, Lee T, Jan SL, Fu YC, Chen MC, Lin PC, Liao WC, Chen CC (2007) Vertebral and carotid artery anomalies in patients with aberrant right subclavian arteries. Pediatr Radiol 37:1007–1012CrossRefPubMedGoogle Scholar
  85. 85.
    Uchino A, Saito N, Takahashi M, Okada Y, Kozawa E, Nishi N, Mizukoshi W, Nakajima R, Watanabe Y (2013) Variations in the origin of the vertebral artery and its level of entry into the transverse foramen diagnosed by CT angiography. Neuroradiology 55:585–594CrossRefPubMedGoogle Scholar
  86. 86.
    Uchino A, Sawada A, Takase Y, Kudo S (2002) Extreme fenestration of the right vertebral artery: Magnetic resonance angiographic demonstration. Eur Radiol 12:32–34Google Scholar
  87. 87.
    Ugurlucan M, Sayin OA, Surmen B, Alpagut U, Dayioglu E, Onursal E (2006) Common carotid trunk and right vertebral artery originating from the right common carotid artery in a patient with carotid stenosis. J Card Surg 21:423–424CrossRefPubMedGoogle Scholar
  88. 88.
    Ulusoy OL, Sasani H, Barlas SB, Mutlu A, Sasani M (2016) A case of anomalous origin and course of vertebral artery in a patient with Klippel Feil syndrome. Korean J Radiol 17:554–557CrossRefPubMedPubMedCentralGoogle Scholar
  89. 89.
    Vicko G, Goran I, Damjan M, Sanja P (1999) Anomalous origin of both vertebral arteries. Clin Anat 12:281–284CrossRefGoogle Scholar
  90. 90.
    Vitte E, Feron JM, Guérin-Surville H, Koskas F (1985) Anatomical study of digital compression of the vertebral artery at its origin and at the suboccipital triangle. Anat Clin 7:77–82CrossRefPubMedGoogle Scholar
  91. 91.
    Vorster W, Du Plooy PT, Meiring JH (1998) Anomalous origin of internal thoracic and vertebral arteries. Clin Anat 11:33–37CrossRefPubMedGoogle Scholar
  92. 92.
    Vučurević G, Marinković S, Puškaš L, Kovačević I, Tanasković S, Radak D, Ilić A (2013) Anatomy and radiology of the variations of aortic arch branches in 1266 patients. Folia Morphol (Warsz) 72:113–122Google Scholar
  93. 93.
    Wasserman BA, Mikulis DJ, Manzione JV (1992) Origin of the right vertebral artery from the left side of the aortic arch proximal to the origin of the left subclavian artery. AJNR Am J Neuroradiol 13:355–358PubMedGoogle Scholar
  94. 94.
    Watanabe K, Saga T, Iwanaga J, Tabira Y, Yamaki KI (2015) A rare case of dual origin of the left vertebral artery without convergence. Folia Morphol (Warsz) 75:136–142CrossRefGoogle Scholar
  95. 95.
    Williams GD, AV HM, Schmeckebier M, Edmonds HM, Graul EG (1932) Variations in the arrangement of the branches arising from the aortic arch in american whites and negroes. Anat Rec 54:247–251CrossRefGoogle Scholar
  96. 96.
    Yamaki K, Saga T, Hirata T, Sakaino M, Nohno M, Kobavashi S, Hirao T (2006) Anatomical study of the vertebral artery in Japanese adults. Anat Sci Int 81:1CrossRefGoogle Scholar
  97. 97.
    Yanik B, Conkbayir I, Keyik B, Hekimoglu B (2004) A rare anomalous origin of right vertebral artery: findings on Doppler sonography. J Clin Ultrasound 32:211–214CrossRefPubMedGoogle Scholar
  98. 98.
    Yuan SM (2016). Aberrant origin of vertebral artery and its clinical implications. Braz J Cardiovasc Surg 31:52–59Google Scholar

Copyright information

© Springer-Verlag France SAS, part of Springer Nature 2018

Authors and Affiliations

  • Nikolaos Lazaridis
    • 1
  • Maria Piagkou
    • 2
  • Marios Loukas
    • 3
  • Evangelia-Theophano Piperaki
    • 4
  • Trifon Totlis
    • 1
  • Georgios Noussios
    • 1
  • Konstantinos Natsis
    • 1
  1. 1.Department of Anatomy and Surgical Anatomy, Faculty of Health Sciences, School of MedicineAristotle University of ThessalonikiThessaloníkiGreece
  2. 2.Department of Anatomy, Faculty of Health Sciences, School of MedicineNational and Kapodistrian University of AthensAthensGreece
  3. 3.Department of Anatomical Sciences, School of MedicineSt George’s UniversitySaint George’sGrenada
  4. 4.Department of Microbiology, Faculty of Health Sciences, School of MedicineNational and Kapodistrian University of AthensAthensGreece

Personalised recommendations