Skip to main content

Advertisement

SpringerLink
Log in

Bilateral vertebral arteries arising distal to the left subclavian artery: embryological and anatomical description

  • Anatomic Variations
  • Published:
Surgical and Radiologic Anatomy Aims and scope Submit manuscript

Abstract

Abnormalities in the origin of vertebral arteries are relatively uncommon, but extremely rare when this abnormality happens on both sides. We present an anatomic variation in which both vertebral arteries came from the proximal descending thoracic aorta beyond the left subclavian artery with no other supra-aortic vessels accompanying the abnormality. The right vertebral artery took a retro-oesophageal course (lusoria artery), while the right and the left vertebral arteries enter the transverse foramina at the 7th cervical vertebra. From an embryological point of view, and overall controversial, this anomaly can be explained by the bilateral persistence of the 8th intersegmental artery as the origin of vertebral artery, instead of the dorsal segment of the 7th intersegmental artery being the origin, which is normally the case. The adequate identification of vertebral artery anomalies in complementary explorations is very important to avoid misdiagnosed vertebral occlusions or unexpected vertebral artery injuries during supra-aortic trunks, thyroid, and oesophagus open surgeries, among others, or even over the course of endovascular procedures.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

Data availability

Not applicable.

Code availability

Not applicable.

References

  1. 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(2):174–176

    Article  Google Scholar 

  2. Dodevski A, Tosovska-Lazarova D (2012) Anatomical features and clinical importance of the vertebral artery. Maced J Med Sci 5(3):328–335

    Google Scholar 

  3. Gailloud P (2014) The supreme intercostal artery includes the last cervical intersegmental artery (C7)—angiographic validation of the intersegmental nomenclature proposed by Dorcas Padget in 1954. Anat Rec 297(5):810–818

    Article  Google Scholar 

  4. Goray VB, Joshi AR, Garg A, Merchant S, Yadav B, Maheshwari P (2005) Aortic arch variation: a unique case with anomalous origin of both vertebral arteries as additional branches of the aortic arch distal to left subclavian artery. Am J Neuroradiol 26(1):93–95

    PubMed  PubMed Central  Google Scholar 

  5. Lazaridis N, Piagkou M, Loukas M, Piperaki ET, Totlis T, Noussios G et al (2018) A systematic classification of the vertebral artery variable origin: clinical and surgical implications. Surg Radiol Anat 40(7):779–797. https://doi.org/10.1007/s00276-018-1987-3

    Article  PubMed  Google Scholar 

  6. Park JK, Kim SH, Kim BS, Gukmyung C (2008) Two cases of aberrant right subclavian artery and right vertebral artery that originated from the right common carotid artery. Korean J Radiol 9:3–6

    Google Scholar 

  7. Rathore MH, Sreenivasan VV (1989) Vertebral and right subclavian artery abnormalities in the Down syndrome. Am J Cardiol 63(20):1528–1529

    Article  CAS  Google Scholar 

  8. Schwarzacher SW, Krammer EB (1989) Complex anomalies of the human aortic arch system: unique case with both vertebral arteries as additional branches of the aortic arch. Anat Rec 225(3):246–250

    Article  CAS  Google Scholar 

  9. Singla RK, Sharma T, Sachdeva K (2010) Variant origin of left vertebral artery. Int J Anat Var 3:97–99

    Google Scholar 

  10. Yuan SM (2016) Aberrant origin of vertebral artery and its clinical implications. Braz J Cardiovasc Surg 31(1):52–91

    PubMed  PubMed Central  Google Scholar 

Download references

Acknowledgements

Department of Human Anatomy and Embryology—University of Valencia.

Funding

This study received no funding.

Author information

Authors and Affiliations

  1. Cardiovascular Surgery Department, Hospital Universitari i Politècnic La Fe, Av/Fernando Abril Martorell, 106, 46026, Valencia, Spain

    Iván Martín-González & María Lorena Díez-Solórzano

  2. Department of Surgery, University of Valencia, Valencia, Spain

    Iván Martín-González & María Lorena Díez-Solórzano

  3. Department of Human Anatomy and Embryology, University of Valencia, Valencia, Spain

    Arantxa Blasco-Serra & Alfonso A. Valverde-Navarro

  4. Facultad de Medicina, University of Valencia, Valencia, Spain

    Andrea Colás-López, Manuel Linuesa-Mendoza, Juan José Cortés-Aucejo, Minerva Marta Ekuaga-Eyang & Aitana Jara-Jaquez

  5. Surgical Nursing. Hospital, Clínico Universitario, Valencia, Spain

    María Carmen Cortés-Martínez

Authors
  1. Iván Martín-González
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. María Lorena Díez-Solórzano
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Arantxa Blasco-Serra
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Alfonso A. Valverde-Navarro
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Andrea Colás-López
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Manuel Linuesa-Mendoza
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Juan José Cortés-Aucejo
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Minerva Marta Ekuaga-Eyang
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Aitana Jara-Jaquez
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. María Carmen Cortés-Martínez
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

IM: manuscript writing, project development. MLD: project development, manuscript editing. AB: manuscript writing/reviewing/editing. AAV: manuscript reviewing/editing. AC: illustrations, data collection. ML: data management. JJC: data collection. MME: data collection. AJ: translation, illustrations. MCC: manuscript writing/reviewing/editing. All the authors read and approved the final manuscript.

Corresponding author

Correspondence to María Lorena Díez-Solórzano.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest. The authors have no competing interests to declare that are relevant to the content of this article.

Ethics approval

Formal consent is not required for this type of study.

Informed consent/consent for publication

Patient’s informed consent for scientific publication was given and patient signed informed consent regarding publishing his data.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Martín-González, I., Díez-Solórzano, M.L., Blasco-Serra, A. et al. Bilateral vertebral arteries arising distal to the left subclavian artery: embryological and anatomical description. Surg Radiol Anat 44, 531–534 (2022). https://doi.org/10.1007/s00276-022-02903-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00276-022-02903-0

Keywords

Search

Navigation