Background: The vertebral arteries originate from the first cervical segment of the subclavian artery; both the right and left vertebral arteries supply the upper spinal cord, cerebellum, brain stem, and the posterior part of the cerebrum with oxygenated blood, constituting around 28% of its supply. Vertebral artery (VA) variations are often overlooked during angiographic and anatomic postmortem examinations, yet they are important for diagnosing and treating intravascular diseases such as thrombosis, arteriovenous malformations, cerebral aneurysms, arterial dissection, occlusion, and atherosclerosis. Aim and Objectives: This study aims to identify the origins of the vertebral arteries and assess any abnormalities, such as smaller-than-normal (hypoplastic) arteries. By comparing variations between the right and left vertebral arteries, we seek to understand if significant differences exist. Advanced 3D imaging techniques are employed to ensure precise analysis of the artery structures. Finally, statistical methods are used to determine the significance of any observed differences between the two sides, providing crucial insights for improved diagnosis and treatment planning. Materials and Methods: We conducted a retrospective evaluation of VA variations in 200 patients who underwent diagnostic CT angiography of the head and neck at our department. Patient data were retrieved from our institution’s Picture Archiving and Communication System. We scrutinized both the origins of the VA, as well as fenestrations and vessel hypoplasia. Statistical analysis involved the Chi-square test, with significance set at P < 0.05. Results: The analysis included 400 vessels, with 97% originating from the subclavian artery and 3% showing the left VA originating directly from the aortic arch. Furthermore, 20% of patients had hypoplastic right-sided vertebral arteries, while 11% had hypoplastic left-sided vertebral arteries. Hypoplastic vertebral arteries were observed unilaterally in 27% of cases and bilaterally in 4%. Conclusion: As per the literature, while variations in the origin, course, and branches of the VA often present no symptoms, understanding both the typical VA and its variations is crucial for averting vascular complications during neck surgeries, endovascular therapy, and minimally invasive diagnosis and treatment of cerebral vascular diseases.
Rajkumar et al. (Tue,) studied this question.