Anatomical characterization of the vertebral artery from a local study population using angiography by computed tomography

Abstract

Purpose: Despite most anatomical variations of the vertebral artery (VA) related to the origin and intraforaminal entrance remain asymptomatic because of the collateral irrigation system, it is important to know their anatomical presentation in order to prevent complications than could be neurologically devastating for patients. The aim of this study was to characterize the VA anatomy using computed tomography angiography (CTA) in the Colombian population. Methods: Study was descriptive, observational and cross–sectional. Neck and thorax CTA studies performed between 2010 and 2017 in adult population were reviewed. Studies with low image-quality or artifacts, or patients with vascular malformations or injuries history, as well as non-Colombian patients were excluded. Frequencies and percentages were calculated. Results: 500 CTA were studied, 362 (72.4%) from male patients, 138 (27.6%) from female patients. In the 18% (n = 90) of the study population, there was at least one VA variation; 73.33% (n = 66) of these cases were male patients and 26.67% (n = 24) were female patients, however, the percentage of VA variations was similar in both genders (18.23% men, 17.39% women). Conclusion: Our findings suggest that the VA anatomy should be assessed prior to any surgical procedure in thoracic or neck region that involves the VA as any complication may be deleterious for the patient. Patients with neurological symptoms and VA variations should be evaluated for arterial dissection. VA variants should be included in the radiology report as they may be useful for clinicians not only for diagnostic but also for preventive purposes.

Keywords

• Vertebral artery
• Anatomic variation
• Computed tomography angiography
• Vertebral artery dissection