TY - JOUR
T1 - Normal and Abnormal Development of Left Vertebral Artery and Its Implications in Cervical Region Surgery
AU - Vasan, Nagaswami
AU - Hilt, Elizabeth
AU - Patil, Pallavi
AU - Schreiber, Olivia
AU - Shahzad, Ahmed
AU - Gill, Tanner
AU - Melovitz-Vasan, Cheryl
N1 - Publisher Copyright:
© 2022, IMED Research Publications. All rights reserved.
PY - 2022/7/1
Y1 - 2022/7/1
N2 - Aortic arch (AA) anomalies occur in approximately 3-5% of cadavers, but these atypical branches remain a point of discussion in cervical region surgery. This case report describes a 73-year-old Caucasian female who died of renal failure following a complicated urinary tract infection whose left vertebral artery (LVA) originated from the AA between the left common carotid and subclavian arteries. The preforaminal part of the LVA was 5 mm in diameter and entered the C6 transverse foramen while the right vertebral artery (RVA) arose from the right subclavian was 6.5 mm in diameter and entered the C5. Embryologically, VAs are formed during weeks four through eight by development of longitudinal anastomoses linking the cervical intersegmental arteries (ISA). The ISA regress except the seventh, which becomes the proximal subclavian artery, the point of origin of the adult VA. Persons with LVA that arises from the AA may be asymptomatic; however, secondary dilatation of the RVA may be implicated in the development of cerebrovascular disorders and atherosclerotic changes due to increased blood flow. Additionally, the anatomical positioning of a left vertebral artery is important when considering an anterior approach for cervical spine surgery and other head-neck procedures when soft structures arteries, veins and muscles are retracted to reach the cervical spine.
AB - Aortic arch (AA) anomalies occur in approximately 3-5% of cadavers, but these atypical branches remain a point of discussion in cervical region surgery. This case report describes a 73-year-old Caucasian female who died of renal failure following a complicated urinary tract infection whose left vertebral artery (LVA) originated from the AA between the left common carotid and subclavian arteries. The preforaminal part of the LVA was 5 mm in diameter and entered the C6 transverse foramen while the right vertebral artery (RVA) arose from the right subclavian was 6.5 mm in diameter and entered the C5. Embryologically, VAs are formed during weeks four through eight by development of longitudinal anastomoses linking the cervical intersegmental arteries (ISA). The ISA regress except the seventh, which becomes the proximal subclavian artery, the point of origin of the adult VA. Persons with LVA that arises from the AA may be asymptomatic; however, secondary dilatation of the RVA may be implicated in the development of cerebrovascular disorders and atherosclerotic changes due to increased blood flow. Additionally, the anatomical positioning of a left vertebral artery is important when considering an anterior approach for cervical spine surgery and other head-neck procedures when soft structures arteries, veins and muscles are retracted to reach the cervical spine.
UR - http://www.scopus.com/inward/record.url?scp=85137755822&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85137755822&partnerID=8YFLogxK
U2 - 10.16965/ijar.2022.176
DO - 10.16965/ijar.2022.176
M3 - Article
AN - SCOPUS:85137755822
SN - 2321-8967
VL - 10
SP - 8426
EP - 8429
JO - International Journal of Anatomy and Research
JF - International Journal of Anatomy and Research
IS - 3
ER -