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Anatomy of vertebral artery hypoplasia and its relationship with clinical implications: a systematic review and meta-analysis of prevalence

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Abstract

Purpose

The vertebral artery (VA) is a vital branch of the subclavian artery, coursing through the transverse foramina of the cervical vertebrae, and playing a crucial role in irrigating the posterior region of the arterial cerebral circle, also known as the Polygon of Willis. Among the various possible alterations that can affect the VA, vertebral artery hypoplasia (HAV) emerges as a significant variant. This study aims to discern the anatomical features of HAV and its correlation with the clinical conditions of the posterior cerebral circulation.

Methods

The databases Medline, Scopus, Web of Science, Google Scholar, CINAHL, and LILACS were searched until January 2024. Two authors independently performed the search, study selection, and data extraction. Methodological quality was evaluated with an assurance tool for anatomical studies (AQUA). Pooled prevalence was estimated using a random effects model.

Results

A total of 24 studies met the established selection criteria, with a total of 8847 subjects. In this study, 6 articles were included for the meta-analysis with a total of subjects. The average prevalence of VAH reported in each study was 11% (95% CI 10–12%); the studies had a heterogeneity of 41% based on the funnel plot and a low risk of bias.

Conclusion

The prevalence of VAH is low, but in the presence of this condition, the changes are mainly in diameter rather than morphological. If it is present, some clinical safeguards must be taken to avoid complications such as stroke.

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Data availability

Not applicable, if additional information is necessary, you can contact the corresponding author.

Abbreviations

VA:

Vertebral artery

VAH:

Vertebral artery hypoplasia

sVAD:

Spontaneous vertebral artery dissection

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Author information

Authors and Affiliations

  1. Escuela de Medicina, Universidad Finis Terrae, 7501015, Santiago, Chile

    Mathias Orellana-Donoso

  2. Department of Morphology and Function, Faculty of Health and Social Sciences, Universidad de Las Américas, 8370040, Santiago, Chile

    Juan José Valenzuela-Fuenzalida

  3. Departamento de Morfología, Facultad de Medicina, Universidad Andrés Bello, 8370146, Santiago, Chile

    Juan José Valenzuela-Fuenzalida, Constanza Pamela Rojas-Navia, Amanda Paz Quirós-Clavero, Macarena Rodriguez-Luengo, Pablo Nova-Baeza, Mathias Orellana-Donoso & Alejandro Bruna-Mejias

  4. Departamento de Ciencias Química y Biológicas, Facultad de Ciencias de La Salud, Universidad Bernardo O’Higgins, 8370993, Santiago, Chile

    Álvaro Becerra Farfán

  5. GIAVAL Research Group, Department of Anatomy and Human Embryology, Faculty of Medicine, University of Valencia, 46001, Valencia, Spain

    Juan Sanchis-Gimeno

  6. Department of Oral and Maxillofacial Anatomy, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan

    Joe Iwanaga

  7. Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, LA, USA

    Joe Iwanaga

  8. Department of Neurology, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, LA, USA

    Joe Iwanaga

  9. Department of Structural & Cellular Biology, Tulane University School of Medicine, New Orleans, LA, USA

    Joe Iwanaga

  10. Faculty of Health and Social Sciences, Universidad de Las Américas, 8370040, Santiago, Chile

    Walter Sepúlveda-Loyola

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  1. Juan José Valenzuela-Fuenzalida
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Contributions

Juan José Valenzuela: Protocol/project development, Data analysis, Manuscript writing/editing. Constanza Rojas Navia: Protocol/project development, Data analysis, Manuscript writing/editing. Amanda Quirós- Clavero: Protocol/project development, Data analysis, Manuscript writing/editing. Juan Sanchis- Gimeno: Data analysis, Manuscript writing/editing. Macarena Rodríguez- Luengo: Manuscript writing/editing. Pablo Nova- Baeza: Data collection or management. Mathias Orellana- Donoso: Data collection or management. Alvaro Becerra Farfan: Protocol/project development, Data analysis, Manuscript writing/editing. Alejandro Bruna- Mejias: Manuscript writing/editing. Walter Sepulveda- Loyola: Data analysis, Manuscript writing/editing. Joe Iwanaga: Final revision and Manuscript writing/editing.

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Correspondence to Juan José Valenzuela-Fuenzalida.

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Valenzuela-Fuenzalida, J.J., Rojas-Navia, C.P., Quirós-Clavero, A.P. et al. Anatomy of vertebral artery hypoplasia and its relationship with clinical implications: a systematic review and meta-analysis of prevalence. Surg Radiol Anat (2024). https://doi.org/10.1007/s00276-024-03377-y

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