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      Two Cases of Left Vertebral Artery Emerging from a Trunk in Common with the Left Subclavian Artery from the Aortic Arch Translated title: Dos Casos de Arteria Vertebral Izquierda Naciendo de un Tronco Común con la Arteria Subclavia Izquierda del Cayado Aórtico

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          Abstract

          Anomalies arising in the embryological development of the aortic arch and its branches are essencial in the emergence of variations in the origin and course of supra aortic vessels. Classically, 95% of cases, the aortic arch gives rise to the brachiocephalic artery, left common carotid artery and left subclavian artery. While the left vertebral artery arises normally from the left subclavian artery. In this presentation we describe two cases of the left vertebral artery being born of the aortic arch. The importance of anatomical knowledge of this arterial variety is fundamental for base neck and aortic arch surgery, in cervicothoracic trauma that compromises the vascular elements and in endovascular procedures in the region.

          Translated abstract

          Anomalías desarrolladas en la evolución embriológica del arco aórtico y sus ramos son fundamentales en la aparición de variaciones en el origen y trayecto de los vasos supra aórticos. Clásicamente, en el 95% de los casos, el arco aórtico da nacimiento a las arterias braquiocefálica, carótida común izquierda y subclavia izquierda. Mientras que la arteria vertebral izquierda nace normalmente de la arteria subclavia izquierda. En este trabajo se exponen dos casos de la arteria vertebral izquierda naciendo del arco aórtico. La importancia del conocimiento anatómico de esta variedad arterial es trascendente para la cirugía de la base del cuello, cayado aórtico, en los traumatismos cervicotorácicos que comprometen los elementos vasculares y en procedimientos endovasculares de la región.

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          Most cited references15

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          High incidence of arterial dissection associated with left vertebral artery of aortic origin.

          The incidences of arterial dissection of the vertebral artery (VA) of aortic origin and VA of subclavian artery origin were determined. The origins of the left and right VAs were confirmed by angiography in 860 and 717 patients, respectively. Left VA of aortic origin was found in 21 patients (6 females and 15 males) but no right VA of aortic origin was found. Left VA of left subclavian artery origin was found in 837 patients and right VA of right subclavian artery origin in 717 patients. Arterial dissection of the VA occurred in 17 patients (6 females and 11 males), four patients with left VA of aortic origin, seven with left VA of left subclavian artery origin, four with right VA of right subclavian artery origin, and two with bilateral VAs of subclavian artery origin. Left VA of aortic origin (4 of 21 patients) was associated with a significantly higher incidence of VA dissection than left VA of left subclavian artery origin and right VA of right subclavian artery origin (p < 0.001). Left VA of aortic origin is associated with a predilection for VA dissection in comparison to VA of subclavian artery origin.
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            Surgical anatomy of the subclavian artery and its branches.

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              Anomalous origin of both vertebral arteries.

              The authors describe a case of an unusual origin of both vertebral arteries in a singular cadaver. On the left, the artery arises directly from the common trunk of vertebral and subclavian artery at the aortic arch and enters the transverse cervical foramina at C VI. On the right, the artery originates from the right common carotid artery and enters the transverse foramina at C III. Additional anomalies were observed on the aortic arch: the common trunk of both common carotid arteries, the common trunk of the left vertebral and subclavian artery, and as a last branch, the retroesophageal right subclavian artery. The morphometric measurements of the vertebral arteries were performed. The literature on the variations of the vertebral arteries is reviewed and their clinical importance for diagnostical procedures and head and neck surgery stressed. Copyright 1999 Wiley-Liss, Inc.
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                Author and article information

                Journal
                ijmorphol
                International Journal of Morphology
                Int. J. Morphol.
                Sociedad Chilena de Anatomía (Temuco, , Chile )
                0717-9502
                June 2013
                : 31
                : 2
                : 646-649
                Affiliations
                [01] orgnameUniversity of Buenos Aires orgdiv1School of Medicine orgdiv2Department of Anatomy Argentina
                [02] orgnameUniversity of Buenos Aires orgdiv1School of Medicine orgdiv2Department of Anatomy Argentina
                Article
                S0717-95022013000200049 S0717-9502(13)03100200049
                10.4067/S0717-95022013000200049
                6664cd71-672c-4eba-afa8-c37c1a0c7fb9

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

                History
                : 24 June 2012
                : 27 February 2013
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 15, Pages: 4
                Product

                SciELO Chile


                Left vertebral artery,Aortic arch,Thorax,Arteria vertebral izquierda,Arco de la aorta,Tórax

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