Prevalence and anatomy of anomalous left vertebral artery originated from aorta evaluated by computed tomographic angiography
We evaluated anatomical characteristics and clinical significance of left vertebral artery (VA) originating from aortic arch (AA) by computed tomography (CT) angiography.
CT angiography was performed in 3460 patients between March 01, 2014 and November 30, 2015. We examined course of prevertebral VA (PVVA) segment and level of entry into the cervical vertebra transverse foramen (CVTF) of left VA originated from AA.
One hundred fifty-three of 3460 patients had left VA originated from AA. Six of 153 patients had dual origin of VA. Entry level to CVTF of 156 left VAs in 153 cases ranged from C3 to C6. Entry level to CVTF of 156 right VAs in 153 cases ranged from C3 to C7. One hundred fifty-six right PVVA segments positioned in longus colli muscle lateral side in 112 VAs, longus colli muscle anterior surface near longus colli muscle lateral margin in 41 VAs, and unknown location in three VAs. One hundred fifty-six left PVVA segments positioned in anterior surface of longus colli muscle midline in 5 cases, anterior surface of longus colli muscle near longus colli lateral margin in 138 cases, longus colli muscle lateral side in 12 cases, and anterior surface of anterior scalene muscle midline in one case.
Left VA may arise from the AA. If a long PVVA segment entering higher CVTF is present, operator can perform anterior cervical surgery via contralateral approach for avoidance of VA injury.
KeywordsLeft vertebral artery Clinical significance Aorta Transverse foramen
This work was supported by research Grant from a National Medical Center.
Compliance with ethical standards
Conflict of interest
We declare that we have no conflict of interest with any organization or institute.
- 3.Einstein EH, Song LH, Villela NL, Fasani-Feldberg GB, Jacobs JL, Kim DO, Nathawat A, Patel D, Bender RB, Peters DF (2016) Anomalous origin of the left vertebral artery from the aortic arch. Aorta (Stamford) 4(2):64–67Google Scholar
- 15.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(4):327–333. https://doi.org/10.1007/s00062-012-0171-0 CrossRefPubMedGoogle Scholar
- 17.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(5):319–323. https://doi.org/10.1007/s00276-008-0442-2 CrossRefPubMedGoogle Scholar
- 19.Shin IY, Chung YG, Shin WH, Im SB, Hwang SC, Kim BT (2008) A morphometric study on cadaveric aortic arch and its major branches in 25 korean adults: the perspective of endovascular surgery. J Korean Neurosurg Soc 44(2):78–83. https://doi.org/10.3340/jkns.2008.44.2.78 CrossRefPubMedPubMedCentralGoogle Scholar
- 20.Singla RK, Sharma T, Sachdeva K (2010) “Variant origin of left vertebral artery”. Int J Anat Var 3:97–99Google Scholar
- 22.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(5):585–594. https://doi.org/10.1007/s00234-013-1142-0 CrossRefPubMedGoogle Scholar