Cervical Vertebral Artery Variations: An Anatomic Study
S.R. Sattia,
C.A. Cernigliab and
R.A. Koenigsberga
a Department of Diagnostic Radiology, Hahnemann University Hospital, Drexel University College of Medicine, Philadelphia, Pa
b Department of Imaging Sciences, University of Rochester Medical Center, University of Rochester School of Medicine and Dentistry, Rochester, NY
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Fig 1. Digital subtraction angiography. There is opacification of the left vertebral artery (LV) as the 2nd branch off the left subclavian artery (LS, arrow). The 1st branch of the left subclavian artery is the thyroid, and the 3rd branch is the cervical artery (CA).
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Fig 2. LV as the 2nd branch off the LS between the TA (thyroid artery) and the CA. RV indicates the right vertebral artery; RS, right subclavian artery; IA, innominate artery; RC, right common carotid artery; LC, left common carotid artery; TA, inferior thyroid artery.
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Fig 3. Digital subtraction angiography. There is opacification of the LV as the 3rd branch off the aortic arch (red arrows) with retrograde flow into a hypoplastic duplicated limb (black arrow), which arose as the 2nd branch of the LS.
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Fig 4. LV has 2 origins. The 1st originates as the 3rd branch of the aortic arch, and the 2nd, as the 1st branch of the LS. There is an incidentally noted bovine arch. RTC indicates right thyrocervical trunk; LTC, left thyrocervical trunk.
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Fig 5. Digital subtraction angiography. Aortogram with the pigtail catheter placed in the proximal descending aorta demonstrates filling of right vertebral artery (red arrows) as the last great vessel off of the arch. The right vertebral artery crosses the midline and extends cranially along the right lateral aspect of the neck.
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Fig 6. RV arises as the last branch off of the aorta. RS indicates right subclavian artery; RC, right common carotid artery.
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Fig 7. Digital subtraction angiography. There is opacification of the RV (red arrows) as the 2nd branch off the RS. The 1st branch of the RS is the thyroidea ima artery (TI) (black arrowheads), and the 3rd branch is the TA.
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Fig 9. Digital subtraction angiography. There is opacification of a duplicated RV (red arrows). The origin (black arrow) is at the normal position as the 2nd branch of the RS.
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Fig 10. The RV is partially duplicated with a common origin as the 2nd branch off the RS. LTC indicates left thyrocervical trunk.
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Fig 11. Normal schematic diagram of the primitive ventral and dorsal aorta, 6 aortic arches, dorsal aortic root segments (DARS), and 7th dorsal intersegmental artery (DISA).
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Fig 12. Normal schematic diagram of the aortic arch and the great vessels demonstrates the embryologic origins of the arch and its major branches. RIC indicates right internal carotid artery; REC, right external carotid artery, LIC, left internal carotid; LEC, left external carotid artery.
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