Coexistence of an aberrant right subclavian artery and anomalous origins of bilateral vertebral arteries: A case report

Simultaneous Association of Variations in the Origin and Diameter of the Left Vertebral Artery in a Patient with a C1 Lateral Mass Tumor

The anomalous origin of a hypoplastic Left Vertebral Artery (LVA) from the aortic arch is a rare anatomic variant. This study discusses the case of a patient with a C1 lateral mass tumor that surrounded a dominant Right Vertebral Artery (RVA) according to preoperative computed tomography angiography, with a hypoplastic LVA originating from the aortic arch. Surgery was performed, and the patient recovered uneventfully. To date, no study has reported the simultaneous association of two variations (origin and diameter) in the LVA. A deep understanding of abnormalities in the diameter and origin of LVA is a must for neurosurgeons as well as for thoracic and vascular surgeons to conduct surgical procedures.

Anatomical variations of the aortic arch branching pattern using CT angiography: a proposal for a different morphological classification with clinical relevance

The aortic arch (AA) branching pattern variations are usually asymptomatic, but they may lead to complications during cardiovascular procedures. In this retrospective study, we aimed to analyze the frequency of anatomical variations of the AA and to develop a different approach of morphological classification based on radiological criteria. 1026 computed tomography angiography scans of adults were evaluated and the presence of left-sided (LAA) and right-sided (RAA) AA were determined in 1023 (99.71%) and 3 (0.29%) of patients, respectively. According to the number of branches, LAA branching pattern of each patient was subclassifed in five morphological types. Based on the order and type-specific reference points, an anomalous LAA variants were classified into 20 subtypes. Type 1 (Typical branching pattern) LAA was identifed in 781 (76.12%) of the patients. Among 242 aberrant LAA variants (four types, 23.58%), the most common subtypes; Type 2A with brachiocephalico-carotid trunk (BCT), Type 4A₁ with an aberrant left vertebral artery (ALVA), and Type 3A₁, in which BCT coexisted with ALVA, were observed in 17.6%, 3.6%, and 0.88% of the cases, respectively. The frequency of remaining LAA variants ranged from 0.39% to 0.097%. In addition, Type 3B₂ and Type 4C were first identified in our study. We observed Type I and II RAA in one female (0.097%) and two cases (male and female, 0.19%), respectively. Knowledge of AA branching variations is of great interest in neck and thoracic surgery and the new morphological types in clinically applicable form recommended in this study can be used in endovascular interventions.