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Embryology of the Anomalous Left Vertebral Artery and its Implications in Neck Surgery
Author(s) -
Vasan Nagaswami,
Vasan Cheryl,
Varricchio Paolo,
DeFouw David
Publication year - 2012
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.26.1_supplement.722.3
Subject(s) - medicine , vertebral artery , anatomy , aortic arch , foramen , cadaveric spasm , anastomosis , stenosis , subclavian artery , common carotid artery , cadaver , carotid arteries , radiology , cardiology , surgery , aorta
Anomalous branches of the aortic arch (AA) occur frequently but are poorly explained. In an 82‐year old Caucasian male cadaver who died of coronary artery disease with severe aortic stenosis, the left vertebral artery (LVA) originated from the AA between the common carotid and subclavian arteries. The prevertebral part of LVA was also tortuous, narrower and entered the C5 transverse foramen. The right vertebral artery (RVA) from the right subclavian was wider than the left suggesting compensation to the cerebral circulation. Respectively, the inner and outer diameters of LVA were 2.5and 3.6 mm and of RVA were 5.6 and 6.0 mm. Prevalence of LVA arising from AA was reported at 2.4–5.8% of cadaveric specimens. An anomalous LVA may be asymptomatic; however, it is important in neck and supraaortic arch vascular surgery and in other noninvasive neck procedures. Embryologically, VA is formed by development of longitudinal anastomoses linking the cervical intersegmental arteries. These intersegmental arteries regress except the seventh, which becomes the proximal subclavian artery, the point of origin of the adult VA. When LVA arises from AA proximal to the subclavian artery, the 6 th dorsal intersegmental artery might have persisted. (Supported by the Department of Cell Biology and Molecular Medicine).