Evaluation of vertebral artery dominance, hypoplasia and variations in the origin: angiographic study in 254 patients.

BACKGROUND: The aim of this study was to determine the dimensional characteristics and variations in the origin of vertebral arteries (VA). MATERIALS AND METHODS: We retrospectively reviewed angiographic studies in 254 patients (133 males, 121 females) for the evaluation of diameter differences in VA. We examined different criteria from the literature (difference of ≥ 0.3 mm, ≥ 0.8 mm, ≥ 1 mm between the widths of two VA and diameter ratio more than 1.4) to find out the dominant VA, rate of co-dominance and hypoplasia. The differences among groups were analysed using the c2 and Kruskal-Wallis test. Also concordance analysis test was used to determine correspondence between the tests. We also noticed the variations in the origin of VA. RESULTS: The average diameter of VA in 254 patients was 3.21 ± 0.7 mm on the right, and 3.16 ± 0.7 mm on the left. The average diameter difference was found 0.88 ± 0.7 mm. The rate of hypoplasia was found 7.1% on the right and 9.4% on the left. Among 254 patients according to the criterion of any diameter difference; right side was found wider in 126 (49.6%) patients and left side was found wider in 120 (47.2%) patients. The criterion of 0.3 mm or greater difference showed right VA dominance in 107 (42.1%) patients, left VA dominance in 99 (39%) patients. Co-dominance was mainly observed when we used the criteria of 0.8 mm and 1 mm or greater difference and diameter ratio more than 1.4. We found out harmony of two criterion of difference of ≥ 0.8 mm and ≥ 1 mm (concordance analysis test, 76.1%). There was no statistically significant relation between age, gender and any dominance criteria (p > 0.05). The majority of VA showed classical origin arising from both subclavian arteries with a rate of 94.9%. CONCLUSIONS: The most striking result we have found is the dominance of the right VA in diameter by using all different criteria unlike with previous reports in the literature.

A case of a rare aortic arch variation: the avian form.

Variations in the branching pattern of the aortic arch are multiple. The avian form is an extremely rare anatomical variation with only a few reported cases in the literature. Herein we report a case of avian variation with two branches arising from the aortic arch: a bicarotid trunk and a common origin for bilateral subclavian arteries.