Bifid origin of the left vertebral artery

Two patients demonstrating a bifid origin of the left vertebral artery are described. The embryologic origin of this anomaly is reviewed together with diagnostic and therapeutic implications, emphasizing the importance of knowledge and recognition of the anomaly. It is suggested that this anomaly is not as rare as previously thought.     

Left vertebral artery origin from the thyrocervical trunk: a unique vascular variant

The vertebral artery normally arises from the subclavian artery, and variations in its origin have been described. We describe a unique case of the left vertebral artery arising from the thyrocervical trunk.     

Aortic arch variation: a unique case with anomalous origin of both vertebral arteries as additional branches of the aortic arch distal to left subclavian artery

We present the case of bilateral anomalous origin of both vertebral arteries (VAs) in a 20-year-old male patient who presented for routine contrast-enhanced CT follow-up examination of the chest. Contrast-enhanced CT revealed abnormal origins of both the VAs from the aortic arch distal to the origin of the left subclavian artery. Following this, CT angiography was performed, which confirmed the findings. To our knowledge, this is the first report of anomalous origins of both VAs beyond the origin of the left subclavian artery. The possible embryonic mechanism and the clinical importance of this variant is also reviewed.     

Duplicate origin of left vertebral artery

Summary A verified case of duplicate origin of the left vertebral artery in association with a large aneurysm arising from the aortic arch immediately distal to the left subclavian artery is presented. An anomalous left vertebral artery arises directly from the aortic arch between the left common carotid and subclavian arteries, and joins with the normal left vertebral artery in the transverse foramen of the fifth cervical vertebra.     

The five-vessel arch: independent origin of both vertebral arteries from the aortic arch

An independent origin of the left vertebral artery from the aortic arch is the second most common aortic arch anomaly and occurs in 7% of otherwise healthy persons. Bilateral and independent origins of vertebral arteries are distinctly unusual. We present and illustrate such a case.     

Duplicated origin of right vertebral artery with rudimentary and accessory left vertebral arteries

Summary We observed a rare cerebrovascular anomaly in a patient with brain-stem infarction. Two right vertebral arteries arose from the subclavian artery and communicated directly with each other under the transverse foramen of the fourth cervical vertebra. The left vertebral artery consisted of a rudimentary artery that arose from the left subclavian artery, ran through the transverse foramen of the sixth cervical vertebra and then tapered down to disappear at the fourth/fifth cervical vertebrae, plus a second, accessory artery that arose from a branch of the left thyrocervical trunk, ran through the transverse foramen of the fifth cervical vertebra and tapered off to disappear at the first/second cervical vertebrae.     

Right aortic arch with isolation of the left innominate artery

Isolation of the left innominate artery and right aortic arch, a rare variant of right aortic arch anomalies, was diagnosed in a four-year-old boy with other congenital cardiac anomalies. Isolation of vessels from the aortic arch is predicted from the primitive double aortic arch model of Edwards. In this patient there was no evidence of a vascular ring or of a significant subclavian steal syndrome.     

Right aortic arch with aberrant left innominate artery: MR imaging findings

A rare case of a 60-year-old man with a right aortic arch and aberrant left innominate artery is presented. This case had an unusual clinical presentation. The dysphagia appeared suddenly in adulthood, whereas vascular rings, when symptomatic, usually manifest early in childhood.To our knowledge, MR imaging findings of this anomaly have never been reported. The diagnosis was made by MR imaging and confirmed by surgery. Magnetic resonance imaging can replace angiography in the assessment of the aortic arch anomalies. Received: 4 April 1997; Revision received: 11 July 1997; Accepted: 3 May 1998     

Klippel-Feil syndrome and Sprengel deformity combined with an intraspinal course of the left subclavian artery and a bovine aortic arch variant

SUMMARY: We present a case of Klippel-Feil syndrome and Sprengel deformity with a bovine aortic arch and an aberrant course of the left subclavian artery in a 14-year-old boy. CT and MR imaging of the neck and upper thorax demonstrated a cervical osseous segmentation anomaly, a left common carotid artery originating from the innominate artery, and a left subclavian artery coursing through the intraspinal space at the C6 through T1 level. Possible embryonic mechanisms and clinical significance of this variant are reviewed.     

Anomalous origin of the right vertebral artery: review of the literature and case report of right vertebral artery origin distal to the left subclavian artery.

We present the case of a 57-year-old patient who was admitted to the hospital for preoperative cerebral angiography because of an intraspinal mass at the level of C1 and C2. Angiographic examination revealed an abnormal origin of the right vertebral artery, which normally originates from the right subclavian artery. Thus, the right vertebral artery was the last branch of the supraaortic vessels. We also review herein the incidence of the various anomalous origins of the right vertebral artery in the literature and discuss their potential embryologic development and clinical significance.     

Right aortic arch with atresia of aberrant left subclavian artery: case report

We report a case of right aortic arch with atresia of the proximal portion of the aberrant left subclavian artery, a rare congenital vascular anomaly. Differential diagnosis from other conditions including right aortic arch with isolation of the left subclavian artery is discussed.     

Fenestration and duplicate origin of the left vertebral artery in angiography

Three cases are shown; 2 of angiographically proven distal fenestration of the left vertebral artery and one of duplicate origin. Both anomalies are classified as of inhibitory type. Their incidence in the literature is reviewed. Underlined is the fact that variations of this nature frequently occur in combination with other inhibitory malformations particularly in the vascular and skeletal systems.     

Bilateral arch origin of the vertebral arteries

A case of bilateral anomalous origins of the vertebral arteries (VAs) is reported. Both VAs arose directly from the aortic arch between the left common carotid artery and the left subclavian artery. The possible embryologic mechanism and clinical importance of this previously unreported variant are reviewed.     

Occluding staghorn calcification of the aortic arch and left subclavian artery: Case report

A calcified thrombus resembling a staghorn was found in the aortic arch, cast into this shape by the aorta and its branching vessel, the left subclavian, into which it projected for a short distance. Unique, in this case, is the extraordinarily large size of the calcification which was mostly free of the vessel wall, its radiological image, and its location. Digital subtraction angiography led to the diagnosis and was confirmed on computed tomography.