Anomalous course and diameter of left-sided vertebral arteries – Significance and predisposing factors in clinical practice

Abstract

The purpose of this study was to determine whether any correlation exists between the level of entry of vertebral arteries (VAs) into the foramen transversarium (FT) and their anomalous course or diameter. To our knowledge there are no studies in the literature concerning the diameter of the vertebral artery (VA) as an impact factor on entrance level. Computed tomography angiography (CTA) images of the aortic arch (AA) and its branches, obtained at the Department of Radiology, Medical University of Łódź from May 2009 to April 2012, were reviewed and the entrance points into the FT were determined. Left vertebral arteries arising directly from the AA more often had an anomalous entrance point to the foramen transversarium and were more frequently hypoplastic. In addition, hypoplastic VAs entered the FT at an anomalous level more often than VAs with normal diameter. The left vertebral arteries arising directly from the aortic arch are often more hypoplastic and often enter the foramen transversarium at a different level from the C6 vertebrae. In patients with hypoplastic VA detected on the basis of ultrasound Color Doppler examination, the presence of anomalies must be considered when planning surgical treatment.