Variablity of the left vertebral artery - accidental autopsy finding and prevalence arch in the population
Abstract
Aim: Based on an accidental autopsy case, the prevalence of similar findings in patients hospitalized at the University Hospital in Pilsen was evaluated. Methods: In a cohort of 570 patients (228 females, 342 males; age 26-87 years), the prevalence and type of atypical branching of the aortic arch (AO) were evaluated with the use of CT angiography.
An accidental finding in the donor body within the anatomical autopsy was assessed. Results: All the aortic arches were left.
Of the 30 findings (corresponds to a prevalence of 5.3%), the most frequently found configuration was the left vertebral artery arising between the left common carotid artery and the left subclavian artery, which also corresponded to the autopsy finding. In patients with atypical AO, the vertebral artery (VA) entered the foramen transversarium (FT) most often at the level of C5 on the left (73.3%) and C6 on the right (73.3%).
Depending on sex, we significantly higher variability in the course of right VA was found in men. In women, the right VA pierced FT C6 most often.
The left VA entered predominantly the FT of C5 in both sexes. Conclusions: Atypical branching of the aortic arch was found in 5.3%, and was often accompanied with an atypical course of the vertebral arteries.
In these patients, the left VA most often entered FT C5, on the right in women it entered exclusively C6. Therefore, in men with anomalous aortic arch or atypia of the left VA, it is necessary to take into account a considerable variability in the course of the right VA as well.