IJAR.2024.218
Type of Article: Original Research
Volume 12; Issue 4 (December 2024)
Page No.: 9072-9078
DOI: https://dx.doi.org/10.16965/ijar.2024.218
Morphometric Analysis of Vertebral Artery in the Scaleno Vertebral Triangle
Rajesh B 1, Rahe R 2, Durga Devi G 3, Krishnaveni Sharath 4, Jinu Merlin Koshy *5.
1 Professor of Anatomy, Sri Lakshmi Narayana Institute of Medical Sciences, Pondicherry, India. ORCiD: 0000-0002-5730-3489
2 Professor of Anatomy, Sree Balaji Medical College & Hospital, Tamil Nadu, India. ORCiD: 0000-0002-0487-0412
3 Professor& HOD of Anatomy , Sree Balaji Medical College & Hospital, Tamil Nadu, India. ORCiD: 0000-0003-1852-8711
4 Professor of Anatomy, Madha Medical College and Research Institute, Tamil Nadu, India. ORCiD: 0000-0001-7714-5804
*5 Associate Professor of Anatomy, Sree Balaji Medical College & Hospital, Tamil Nadu, India. ORCiD: 0000-0002-2072-6576
Corresponding Author: Dr. Jinu Merlin Koshy, Associate Professor of Anatomy, Sree Balaji Medical College & Hospital, Tamil Nadu, India. E-Mail: jinumerlinkoshy@gmail.com
ABSTRACT
Background: The vertebral arteries (VA) play a vital role in supplying blood to the brainstem and cerebellum. Vertebral artery anomalies, including abnormal origins, courses, and structural irregularities, heighten the risk of cerebrovascular events. Typically, the vertebral arteries arise from the posterosuperior aspect of the first part of the subclavian artery. The aim of this study is to present the presence of variation in the origin of vertebral artery
Material and Methods: Twenty-eight embalmed cadavers allotted for 1st year MBBS dissection in the Department of Anatomy were used for the study. The triangle of vertebral artery was exposed in all the cadavers, and examined the origin of vertebral artery. Dimensions of the Triangle of Vertebral artery (TVA) and vertebral artery were then measured using a digital vernier caliper and the area and height of the TVA were calculated.
Result: In the present study, we have evaluated the morphometric parameters of the TVA and vertebral artery. Even though there were no noticeable differences in the boundaries of TVA of both sides, the morphometric parameters showed slight difference in the measurements, but not significant. Among the 28 cadavers the unilateral origin of VA in one cadaver was from the arch of aorta between the left common carotid artery (LCA) and left subclavian artery (LSCA) .
Discussion & Conclusion: The mean height of TVA was 26.3mm (range, 23.7-33.7 mm) on the left and 26.2mm (range, 23.5-32.8 mm) on the right. In the current study it was observed the origin of VA from the arch of aorta between the left common carotid artery (LCA) and left subclavian artery (LSCA). The current study found that 3.6% of the variations in the origin of VA. This study highlights the variation in the origin of the vertebral artery and accentuates the importance of identifying these variations in clinical practice.
Keywords: Vertebral Artery, Subclavian artery, Arch of Aorta, foramen transversarium.
REFERENCES
[1]. Birch R, Collins P, Gray H, Standring S. Gray’s anatomy : The anatomical basis of clinical practice. 41st ed. Philadelphia: Elsevier Limited; 2016.
[2]. Singal A, Gupta T, Sahni D, Aggarwal A. Anatomy of scalenovertebral triangle: A vade mecum for clinicians. Morphologie. 2020 Sep 1;104(346):174-81.
https://doi.org/10.1016/j.morpho.2019.12.004
PMid:31982324
[3]. Daniel John Cunningham, Romanes GJ. Cunningham’s manual of practical anatomy. 3 : Head, neck and brain. Oxford: Oxford University Press; 2004.
[4]. Raymond Jack Last. Anatomy : regional and applied. Edinburgh: Churchill Livingstone; 1985.
[5]. Gaillard F, Sharma R, Scott L, et al. Vertebral artery. Reference article, Radiopaedia.org (Accessed on 18 Sep 2024)
https://doi.org/10.53347/rID-4858
[6]. Singh V. Textbook of Anatomy Head, Neck, and Brain; Volume III. Elsevier Health Sciences; 2018.
[7]. Michalopoulos GD, Pennington Z, Bambakidis P, Alexander AY, Lakomkin N, Charalampous C, et al. Traumatic vertebral artery injury: Denver grade, bilaterality, and stroke risk. A systematic review and meta-analysis. Journal of Neurosurgery. 2024 Feb 1;140(2):522-36.
https://doi.org/10.3171/2023.5.JNS222818
PMid:37548568
[8]. Ramamurti P, Weinreb J, Fassihi SC, Rao R, Patel S. Vertebral Artery Injury in the Cervical Spine. JBJS Reviews. 2021 Jan;9(1):e20.00118-8.
https://doi.org/10.2106/JBJS.RVW.20.00118
PMid:33470592
[9]. Ikegami A, Ohtani Y, Ohtani O. Bilateral variations of the vertebral arteries: The left originating from the aortic arch and the left and right entering the C5 transverse foramina. Anatomical Science International. 2007 Sep;82(3):175-9.
https://doi.org/10.1111/j.1447-073X.2006.00163.x
PMid:17867344
[10]. Lacout A, Khalil A, Figl A, Liloku R, Marcy PY. Vertebral arteria lusoria: a life-threatening condition for oesophageal surgery. Surgical and Radiologic Anatomy. 2011 Sep 8;34(4):381-3.
https://doi.org/10.1007/s00276-011-0867-x
PMid:21901375
[11]. Lee MJ, Weaver DJ, Mostafa. Extracranial Vertebral Artery Injuries. Journal of the American Academy of Orthopaedic Surgeons [Internet]. 2024 May 28 [cited 2024 Oct 9];32(18):e899-908. Available from: https://pubmed.ncbi.nlm.nih.gov/38810231/
https://doi.org/10.5435/JAAOS-D-24-00244
PMid:38810231
[12]. Koshi R, Cunningham DJ. Cunningham’s manual of practical anatomy. Volume 2, Thorax and abdomen. Oxford: Oxford University Press; 2017.
[13]. Tubbs RS, Salter EG, Wellons JC, Blount JP, Oakes WJ. The Triangle of the Vertebral Artery. Operative Neurosurgery. 2005 Apr 1;56(suppl_4):ONS-252-ONS-255.
https://doi.org/10.1227/01.NEU.0000156797.07395.15
PMid:15794821
[14]. Einstein EH, Linda Huijie Song, Natalia Arias Villela, Gregory Brian Fasani-Feldberg, Jacobs JP, Kim DO, et al. Anomalous Origin of the Left Vertebral Artery from the Aortic Arch. Aorta (Stamford). 2016 Apr 1;04(02):64-7.
https://doi.org/10.12945/j.aorta.2015.15.022
PMid:27757404 PMCid:PMC5054757
[15]. Sawant SP. Case Report on Variant Origin of the Vertebral Artery. MOJ Anatomy & Physiology. 2017 Jun 19;3(6).
https://doi.org/10.15406/mojap.2017.03.00115
[16]. Ebraheim NabilA, Lu J, Brown JA, Biyani A, Yeasting RA. Vulnerability of Vertebral Artery in Anterolateral Decompression for Cervical Spondylosis. Clinical Orthopaedics and Related Research. 1996 Jan;322:146-51.
https://doi.org/10.1097/00003086-199601000-00018
[17]. Yamaki KI, Saga T, Hirata T, Masanori Sakaino, Masayuki Nohno, Kobayashi S, et al. Anatomical study of the vertebral artery in Japanese adults. Anat Sci Int. 2006 Jun 1;81(2):100- 6.
https://doi.org/10.1111/j.1447-073X.2006.00133.x
PMid:16800294
[18]. Budhiraja V, Rastogi R, Jain V, Bankwar V, Raghuwanshi S. Anatomical Variations in the Branching Pattern of Human Aortic Arch: A Cadaveric Study from Central India. ISRN Anatomy. 2013 Sep 12;2013:1-5.
https://doi.org/10.5402/2013/828969
PMid:25938106 PMCid:PMC4392960
[19]. Shoja MM;Tubbs RS;Khaki AA;Shokouhi G;Farahani RM;Moein A. A rare variation of the vertebral artery. Folia morphologica [Internet]. 2024 [cited 2024 Sep 27];65(2). Available from: https://pubmed.ncbi.nlm.nih.gov/16773609/
[20]. Satti. Cervical vertebral artery variations: an anatomic study. AJNR American journal of neuroradiology [Internet]. 2016 [cited 2024 Sep 27];28(5). Available from: https://pubmed.ncbi.nlm.nih.gov/1749468