Vertebral arteria lusoria: a life-threatening condition for oesophageal surgery

Lacout, Alexis; Khalil, Antoine; Figl, Andrea; R, Liloku; Marcy, Pierre-Yves

doi:10.1007/s00276-011-0867-x

Cited by 21 publications

(12 citation statements)

References 6 publications

(11 reference statements)

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“…Aberrant origin of VA is a rare variant of VA pathologies implicating in not only cerebrovascular events, but also VA dissection [ 4 ] and surgical anatomy of local regions in particular in the operation of the carotid artery [ 5 ] or aortic arch [ 6 ] . The "vertebral arteria lusoria", although even more rarely seen, should be considered in the patients undergoing esophageal surgery, and unawareness of such an aberrant VA may cause life-threatening events [ 7 ] . Moreover, dual origins of VA should be recognized in preoperative evaluation of patients with extracranial vascular disease [ 8 ] .…”

Section: Introductionmentioning

confidence: 99%

Aberrant Origin of Vertebral Artery and Its Clinical Implications

Yuan¹

2015

Brazilian Journal of Cardiovascular Surgery

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Aberrant origin of vertebral artery is rare. The anatomical features and clinical significance of this lesion remain to be clarified. A comprehensive collection of the pertinent literature resulted in a cohort of 1286 cases involving 955 patients and 331 cadavers. There were more left than right and more unilateral than bilateral aberrant vertebral arteries. Patients with aberrant origin of vertebral artery were often asymptomatic and in only 5.5% of the patients their symptoms were probably related to the aberrant origin of vertebral artery. The acquired cardiovascular lesions were present in 9.5% of the patients, 20.9% of which were vertebral artery-associated lesions. Eight (0.8%) patients had a vertebral artery dissection. Logistic regression analysis showed significant regressions between bovine trunk and left vertebral artery (P=0.000), between the dual origins of vertebral artery and cerebral infarct/thrombus (P=0.041), between associated alternative congenital vascular variants and cervical/aortic dissection/atherosclerosis (P=0.008). Multiple logistic regression demonstrated that side of the aberrant origin of vertebral artery (left vertebral artery) (P=0.014), arch branch pattern (direct arch origin) (P=0.019), presence of the common trunk (P=0.019), associated acquired vascular disorder (P=0.034) and the patients who warranted management (P=0.000) were significant risk predictors for neurological sequelea. The patients with neurological symptoms and those for neck and chest operations/ interventions should be carefully screened for the possibility of an aberrant origin of vertebral artery. The results from the cadaver metrology study are very helpful in the design of the aortic stent. The arch branch pattern has to be taken into consideration before any maneuver in the local region so as to avoid unexpected events in relation to aberrant vertebral artery.

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Section: Introductionmentioning

confidence: 99%

Aberrant Origin of Vertebral Artery and Its Clinical Implications

Yuan¹

2015

Brazilian Journal of Cardiovascular Surgery

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“…Another anastomotic chain found within the upper costotransverse spaces differs from a descending thoracic VA by its caudal origin from a thoracic ISA and its ascending course. 7 This exceptional variant corresponds to an ascending thoracic VA (Fig 1, left) and should not be confused with variants such as a verte-bral arteria lusoria [8][9][10][11][12][13] or persistent left seventh cervical ISA of aortic origin. 14 This report discusses 9 angiographic observations of descending thoracic VAs and 2 cases of ascending thoracic VAs.…”

mentioning

confidence: 99%

Ascending and Descending Thoracic Vertebral Arteries

Gailloud

Gregg

Pearl

et al. 2016

AJNR Am J Neuroradiol

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Thoracic vertebral arteries are anastomotic chains similar to cervical vertebral arteries but found at the thoracic level. Descending thoracic vertebral arteries originate from the pretransverse segment of the cervical vertebral artery and curve caudally to pass into the last transverse foramen or the first costotransverse space. Ascending thoracic vertebral arteries originate from the aorta, pass through at least 1 costotransverse space, and continue cranially as the cervical vertebral artery. This report describes the angiographic anatomy and clinical significance of 9 cases of descending and 2 cases of ascending thoracic vertebral arteries. Being located within the upper costotransverse spaces, ascending and descending thoracic vertebral arteries can have important implications during spine interventional or surgical procedures. Because they frequently provide radiculomedullary or bronchial branches, they can also be involved in spinal cord ischemia, supply vascular malformations, or be an elusive source of hemoptysis.

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“…TEVAR has become the treatment modality of choice because of its lower morbidity and mortality compared with open surgery 7, 8. Direct aortic origin of the LVA is the most frequent anatomic variant of the vertebral artery, with a prevalence of 2.4% to 5.8% 4, 5. Most LVAs with aortic arch origin proximal to the LSA enter the foramen transversarium of the C4 or C5 vertebra.…”

Section: Discussionmentioning

confidence: 99%

“…This can pose a challenge in the presence of an anomalous vertebral, subclavian, or carotid artery origin. A particularly rare scenario is the origin of a left vertebral artery (LVA) directly from the arch of aorta distal to the LSA, which occurs in up to only 3% to 4% of the population 4, 5. This case describes TEVAR in a patient with an atypical LVA arising directly from the arch of aorta distal to the LSA and entering the foramen transversarium of the seventh cervical vertebra.…”

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confidence: 99%

Thoracic endovascular aortic repair in a case of grade III blunt aortic injury with aberrant vertebral artery origin

Baig

Alfozan

Guzman

et al. 2019

Journal of Vascular Surgery Cases, Innovations and Techniques

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Aberrant origin of the left vertebral artery (LVA) can pose a challenge during thoracic endovascular aortic repair. We encountered such a patient who was involved in a motor vehicle accident in whom computed tomography angiography revealed a grade IIIB blunt aortic injury with an anomalous origin of the LVA distal to the origin of the left subclavian artery. On-table aortography confirmed dominance of the LVA. Hence, an open left carotid-vertebral and then left carotid-subclavian artery bypass was performed, followed by thoracic endovascular aortic repair. The patient recovered well and was discharged home 3 days later.

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Vertebral arteria lusoria: a life-threatening condition for oesophageal surgery

Cited by 21 publications

References 6 publications

Aberrant Origin of Vertebral Artery and Its Clinical Implications

Aberrant Origin of Vertebral Artery and Its Clinical Implications

Ascending and Descending Thoracic Vertebral Arteries

Thoracic endovascular aortic repair in a case of grade III blunt aortic injury with aberrant vertebral artery origin

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